At what age should a one-time only colonoscopy for screening of colorectal cancer be performed?

Objective To determine at what age the only screening colonoscopy during lifetime should be performed to achieve the highest yield. Methods Medical decision analysis to calculate the loss in life years associated with mortality from colorectal cancer at different ages. Results The expected loss in life years from colorectal cancer is highest between the ages 70 to 80 years, with a peak occurring at age 75. The length of protection provided by colonoscopy plus polypectomy is estimated to last 5-10 years after the procedure. A screening colonoscopy at age 65 would, thus, protect a subject from age 65 until age 10 or 75 years. Similarly, a screening colonoscopy at age 70 would protect the subject from age 70 until age 75 or 80 years. Conclusions The highest yield in life years by preventing death from colorectal cancer is achieved if the only colonoscopy per lifetime is scheduled between the ages of 65 and 70 years. Eur J Gastroenterol Hepatol 11:1319-1320 (C) 1999 Lippincott Williams & Wilkins.