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CC BY 4.0 · Endosc Int Open 2026; 14: a27883397
DOI: 10.1055/a-2788-3397
Original article

Adenoma detection rates and complications of colonoscopy in patients aged 75 to 79 vs 70 to 74 years: Propensity score-matching study

Authors

  • Osamu Toyoshima  ‡

    1   Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya, Japan (Ringgold ID: RIN577428)

  • Toshihiro Nishizawa  ‡

    1   Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya, Japan (Ringgold ID: RIN577428)
    2   Department of Gastroenterology and Hepatology, International University of Health and Welfare Narita Hospital, Chiba, Japan

  • Shuntaro Yoshida

    1   Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya, Japan (Ringgold ID: RIN577428)

  • Tomoharu Yamada

    1   Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya, Japan (Ringgold ID: RIN577428)
    3   Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan

  • Keisuke Mabuchi

    1   Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya, Japan (Ringgold ID: RIN577428)
    3   Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan

  • Takuma Kaneko

    1   Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya, Japan (Ringgold ID: RIN577428)
    3   Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan

  • Mari Mizutani 

    4   Center for Diagnostic and Therapeutic Endoscopy, Keio University, School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
    1   Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya, Japan (Ringgold ID: RIN577428)

  • Hirotoshi Ebinuma

    2   Department of Gastroenterology and Hepatology, International University of Health and Welfare Narita Hospital, Chiba, Japan

  • Mitsuhiro Fujishiro 

    3   Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan

  • Keisuke Hata

    1   Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya, Japan (Ringgold ID: RIN577428)
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Abstract

Background and study aims

Several guidelines recommend discontinuation of routine surveillance colonoscopy after age 75 years. Because Japan has one of the longest life expectancies, we considered ceasing at age 80 years. We compared patients aged 75 to 79 years with those aged 70 to 74 years, regarding adenoma detection rate (ADR), mean number of adenomas per colonoscopy, and adverse events.

Patients and methods

This propensity score-matching (PSM) study included patients aged 70 to 79 years with a performance status of 0 to 1 who underwent colonoscopies at Toyoshima Endoscopy Clinic between 2017 and 2024. Patients aged 75 to 79 years were matched with those aged 70 to 74 years for baseline characteristics using the propensity score. ADR, mean number of adenomas per colonoscopy, frequency of respiratory depression, hypotension, and delayed post-polypectomy bleeding were compared between the two groups.

Results

During the study period, 3415 patients were included. The ADR in patients aged 75 to 79 years was higher than that in patients aged 70 to 74 years (66.5% vs 62.2%, P = 0.021). Mean number of adenomas per colonoscopy in patients aged 75 to 79 years was higher than that in patients aged 70 to 74 years (1.54 vs 1.38, P = 0.014). The two groups did not show significant differences in respiratory depression (2.6% vs 2.3%), hypotension (0.8% vs 1.0%) or delayed post-polypectomy bleeding (0.2% vs 0.4%).

Conclusions

Colonoscopies for patients aged 75 to 79 are safe and effective in Japan.

Keywords

Endoscopy Lower GI Tract - Polyps / adenomas / ... - CRC screening - Endoscopic resection (polypectomy, ESD, EMRc, ...)


Publication History

Received: 07 March 2025

Accepted after revision: 14 January 2026

Accepted Manuscript online:
14 January 2026

Article published online:
03 February 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Osamu Toyoshima, Toshihiro Nishizawa, Shuntaro Yoshida, Tomoharu Yamada, Keisuke Mabuchi, Takuma Kaneko, Mari Mizutani, Hirotoshi Ebinuma, Mitsuhiro Fujishiro, Keisuke Hata. Adenoma detection rates and complications of colonoscopy in patients aged 75 to 79 vs 70 to 74 years: Propensity score-matching study. Endosc Int Open 2026; 14: a27883397.
DOI: 10.1055/a-2788-3397
 

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