Effectiveness of Endoscopic Cancer Tests Declines After Age 80, Korean Study Shows

Colonoscopy. (Image courtesy of Yonhap)

SEOUL, June 17 (Korea Bizwire) — A new government-backed study has raised doubts about the effectiveness of routine endoscopic screenings for stomach and colorectal cancers in South Koreans aged 80 and older, prompting calls for more individualized screening guidelines for elderly patients.

The Korea Health Industry Development Institute (KHIDI) released a report Monday based on research conducted by Professor Kim Hyun-soo of Wonju Severance Christian Hospital. The findings suggest that while cancer screenings offer measurable benefits for seniors up to their late 70s, their value diminishes significantly for those 80 and above.

Currently, South Korea’s national cancer screening program recommends biennial upper endoscopy or gastrointestinal radiography for adults aged 40 and over for stomach cancer, and fecal occult blood testing every 1–2 years for individuals aged 50 and older for colorectal cancer, followed by colonoscopy if results are positive. Notably, there is no official upper age limit for gastric cancer screening.

Analyzing National Health Insurance claims data from 2004 to 2020, researchers found that colorectal cancer incidence decreased by 30 percent among screening recipients aged 75 to 79. However, the reduction was not observed in those aged 80 and above.

A parallel review of national stomach cancer screening data from 2009 to 2020 showed a 43 percent drop in gastric cancer mortality for individuals aged 75 to 79 who underwent endoscopy. But again, the benefit significantly weakened beyond age 80 and became negligible from age 81 onward.

These results align with current domestic clinical guidelines, which already caution against routine endoscopic screening for those over 80 for colorectal cancer and over 85 for gastric cancer, citing insufficient evidence and potential risks, including increased mortality linked to complications.

Experts participating in KHIDI’s clinical assessment panel stressed the importance of personalized decision-making for older adults. “Routine screening in people over 80 should not be the default,” the panel noted, recommending that factors such as individual health status, life expectancy, and cancer risk be taken into account.

They also underscored the need for shared decision-making between physicians and patients when considering endoscopic procedures in older populations.

Lina Jang (linajang@koreabizwire.com)