Study Finds Metachronous Colorectal Surgery Raises Morbidity, Costs in Patients 75 Plus

Colorectal cancer (CRC) screening faces challenges including limited colonoscopy availability and patient barriers, prompting experts like Dr. Mark Fendrick to advocate for increased use of noninvasive stool-based tests as initial screening tools. Stool DNA and fecal immunochemical tests (FIT) offer convenient, home-based options that can help achieve higher population screening rates without overburdening colonoscopy resources. Additionally, recent research highlights that stool DNA testing has a significantly lower carbon footprint compared to colonoscopy, with environmental concerns becoming a novel factor in screening decisions. Despite the convenience and environmental benefits, positive stool tests still require follow-up colonoscopies, which contribute largely to emissions. Meanwhile, a clinical audit found that patients aged 75 and older who undergo surgery for metachronous colorectal neoplasia after stopping surveillance at 75 experience higher complication rates, longer hospital stays, and increased costs compared to first-time colorectal neoplasia surgeries, underscoring the morbidity and financial impact of current surveillance cessation practices. Balancing effective screening strategies with resource constraints and patient outcomes remains crucial for optimizing CRC prevention and care.