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Colorectal Screening in Older, Sick Patients Reconsidered

Study finds life expectancy after cancer diagnosis less than five years for 81 year olds with multiple illnesses

TUESDAY, Nov. 7 (HealthDay News) -- Colorectal screening in older patients with multiple chronic conditions should be carefully considered because their life expectancy is substantially reduced, according to a report in the Nov. 7 issue of the Annals of Internal Medicine.

Cary P. Gross, M.D., from Yale University School of Medicine in New Haven, Conn., and colleagues conducted a population-based retrospective cohort study of patients aged 67 or older diagnosed with colorectal cancer from 1993 to 1999, to determine the effects of age and coexisting chronic illness on life expectancy.

In the final cohort of 35,755 patients, the investigators found that life expectancy after diagnosis of stage I colorectal cancer for males who were 67 years old decreased from 19.1 years for patients without additional illness to 7.6 years for patients with three or more chronic illnesses. Similar trends were seen in women. Men and women between 76 and 81 with stage I colorectal cancer and three or more chronic diseases had life expectancies of five years or less.

"Coexisting chronic illness is associated with a substantial reduction in life expectancy after diagnosis of early-stage colorectal cancer," the authors write. "Physicians should consider this when deciding whether to screen older persons."

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