摘要
BACKGROUND Elderly patients aged at least 75 years old(Elderly_75),represent 45%of colorectal cancer(CRC)incidence.As others,the French Colorectal Cancer Screening Program(CRCSP)does not include Elderly_75.To date,there is little evidence to justify stopping screening at 74 years of age.AIM To describe CRC fecal screening test completion after age 74,source(CRCSP/Provider ordered)and outcomes of these tests.METHODS The study concerned 18704 Elderly_75 residing in eleven French districts(Ain,Doubs,Essonne,Haute-Saone,Hauts-de-Seine,Jura,Seine-Saint-Denis,Territoire-de-Belfort,Val-de-Marne,Val-d'Oise,Yonne),having performed a CRC screening test between January 2008 and December 2017.The tests performed in a circumstance of delayed response to a solicitation(DRS)from the local cancer screening managing center(Managing-Center)were distinguished from the tests non-solicited by the Managing-Center,performed after a recommendation by a General Practitioner(GP)or other provider ordered(RGP).DRS was any test realized by an Elderly_75 following an initial invitation from the ManagingCenter with a maximum 24 mo after this invitation.Any Non-DRS test was considered RGP.The outcomes of these tests were described according to the circumstances of test completion.RESULTS Of 18995 screening-tests were performed at ages:75(83.5%),76-80(13.4%)and>80(3.1%)years old.Elderly_75 performed the screening test in a circumstance of DRS(71.9%)or RGP(28.1%).The proportion of the tests that could not be analyzed and not restarted was 13.2%.For these unanalyzed tests,the reason was age-related in 78.0%of cases,related to the laboratory's refusal to analyze the test of people aged≥77.Reported colonoscopy completion rate was 81.3%.For those575 people with reported colonoscopy,no complication was listed.18.0%of the366 Elderly_75 with lesions had no anteriority in the CRCSP.The neoplasia(124 Low-risk-polyps,159 High-risk-polyps,13 Unspecified-polyps and 70 CRCs)detection rate was 19.3/1000 Elderly_75 screened and the CRC detection rate was3.7/1
BACKGROUND Elderly patients aged at least 75 years old（Elderly75）, represent 45% of colorectal cancer（CRC） incidence. As others, the French Colorectal Cancer Screening Program（CRCSP） does not include Elderly75. To date, there is little evidence to justify stopping screening at 74 years of age.AIM To describe CRC fecal screening test completion after age 74, source（CRCSP/Provider ordered） and outcomes of these tests.METHODS The study concerned 18704 Elderly75 residing in eleven French districts（Ain,Doubs, Essonne, Haute-Saone, Hauts-de-Seine, Jura, Seine-Saint-Denis,Territoire-de-Belfort, Val-de-Marne, Val-d’Oise, Yonne）, having performed a CRC screening test between January 2008 and December 2017. The tests performed in a circumstance of delayed response to a solicitation（DRS） from the local cancer screening managing center（Managing-Center） were distinguished from the tests non-solicited by the Managing-Center, performed after a recommendation by a General Practitioner（GP） or other provider ordered（RGP）. DRS was any test realized by an Elderly75 following an initial invitation from the ManagingCenter with a maximum 24 mo after this invitation. Any Non-DRS test was considered RGP. The outcomes of these tests were described according to the circumstances of test completion.RESULTS Of 18995 screening-tests were performed at ages: 75（83.5%）, 76-80（13.4%） and >80（3.1%） years old. Elderly75 performed the screening test in a circumstance of DRS（71.9%） or RGP（28.1%）. The proportion of the tests that could not be analyzed and not restarted was 13.2%. For these unanalyzed tests, the reason was age-related in 78.0% of cases, related to the laboratory’s refusal to analyze the test of people aged ≥ 77. Reported colonoscopy completion rate was 81.3%. For those575 people with reported colonoscopy, no complication was listed. 18.0% of the366 Elderly75 with lesions had no anteriority in the CRCSP. The neoplasia（124 Low-risk-polyps, 159 High-risk-polyps, 13 Unspecifie
