Frailty as a Predictor of Colonoscopic Procedural Risk: Robust Associations from Fragile Patients

Colonoscopy, the current “gold standard” for colorectal cancer and precancer detection and removal, is generally recommended for the screening of adults aged 50–75. Through recommendations and guidelines such as the 80% screening rate by 2018 set by the National Colorectal Cancer Roundtable, its use has nearly doubled over the past two decades. Colonoscopy also carries the risk of major complications such as hemorrhage, perforation, and cardiopulmonary events [3], for which the incidence remains low, although its growing use will increase the number of patients experiencing adverse events. Moreover, it may be of limited benefit in a subset of older patients. A method for determining the patients in which the risk of colonoscopy outweighs its benefit has the potential to help clinicians improve the procedural risk/benefit.