Should The Age For Initial Screening Colonoscopy Be Different For Men and Women?

Men have a higher incidence of advanced colon tumors compared to women in all age groups examined in an analysis of more than 40,000 colonoscopy screening results. Thus, the results suggest that the age at which individuals receive an initial screening colonoscopy should be sex specific, according to a study published in the September 28 issue of JAMA.

To determine the most appropriate age for initial screening colonoscopy for both male and female patient groups, Monika Ferlitsch, MD, of the Austrian Society for Gastroenterology and Hepatology, Vienna, Austria, and colleagues conducted a study that included 44,350 participants in a national screening colonoscopy program over a 4-year period (2007-2010) in Austria. Of the participants, 51% were women; the median ages were 60.7 years for women and 60.6 years for men.

Study results showed adenomas were present in 24.9% of men compared to 14.8% of women. The prevalence of adenomas was 18.5% among 50- to 54-year-old men, which was greater than the prevalence among women in the same age group (10.7%), but similar to the prevalence among 65- to 69-year-old women (17.9%).

The rate of colorectal cancer (CRC) was twice as high among men compared with women (1.5% vs 0.7%). An incidence of 1.2% among 65- to 69-year-old women was comparable to that of 55-to 59-year-old men (1.3%).

“In our study, analysis of age- and sex-specific prevalence of adenomas, AAs [advanced adenomas], and CRC indicates a significantly higher rate of these lesions among men compared with women in all age groups, suggesting that male sex constitutes an independent risk factor for colorectal carcinoma and indicating new sex-specific age recommendations for screening colonoscopy,” the authors write.

Furthermore, the researchers point out that “deciding whether to adjust the age at which screening begins also requires considering whether the recommended age for women should be older or the recommended age for men younger.”

Source: JAMA.