Endoscopy
Signal score, how each part rates
ActionabilityPrevalenceStakesEvidence strengthNovelty
See the full rubric →The Safety and Efficacy of Colorectal Endoscopic Submucosal Dissection in the Elderly: A Large Western Analysis of 710 Lesions.
Clinical takeawayConsider colorectal ESD for Western elderly patients (≥75) with laterally spreading lesions, as it is safe and effective compared to younger cohorts despite higher comorbidities, antithrombotic use, and a slightly higher length of stay.
What it foundEn-bloc resection rates (87.4%, 80.9%, 80.2%) and R0 resection rates (69.6%, 68%, 61.5%) were comparable across age groups (<65, 65-75, ≥75), with no significant difference in adverse events (6.7%, 8.5%, 6.3%).
ContextConfirms safety and efficacy of ESD in Western elderly patients, extending prior Eastern data to a Western cohort with different patient and lesion characteristics.
Refinessuggested applicable standard· U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017
Decision at stakethe safety and efficacy of colorectal ESD in elderly patients
U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017 · reviewed 2026-07-23 ↗Begin average-risk colorectal cancer screening at age 45 using a patient-centered shared-decision modality choice, colonoscopy every 10 years (preferred) or annual FIT as Tier 1 options, with multi-target stool DNA every 3 years, CT colonography every 5 years, or flexible sigmoidoscopy every 5 to 10 years as Tier 2 alternatives. A positive stool-based test requires diagnostic colonoscopy, and stool tests should not be ordered for patients who would decline follow-up colonoscopy. Generally stop at age 75 with individualized decisions for ages 76-85 and no screening beyond 85.
Ayoub F … Othman M · Journal of Clinical Gastroenterology · IF 2.9 · PubMed ↗