Age-Related Increase in Post-Colonoscopy Adverse Events: A Study

In a recent study published in Clinical Gastroenterology and Hepatology on June 13, 2025, researchers have found that adverse event rates within 30 days following surveillance colonoscopy procedures rise with patient age, especially among those aged 76 to 85 years. Despite this increase, adverse events remain infrequent, occurring in less than 1% of procedures. The study, led by Dr. Jeffrey K. Lee at Kaiser Permanente Northern California, analyzed data from 84,172 surveillance colonoscopies performed between 2010 and 2019, focusing on patients with a history of precancerous adenomas.

The methodology involved logistic regression to assess the relationship between age and the risk of adverse events, which included emergency department visits, hospitalizations, and mortality related to specific conditions such as colonic perforation and strokes. The findings highlight that gastrointestinal bleeding is the most common adverse event, with rates significantly increasing among older patients. Specifically, those aged 76-85 years experienced 69.6 events per 10,000 procedures, with gastrointestinal bleeding accounting for 39.2 events and stroke for 18.3 events per 10,000 procedures.

The study also noted that significant risk factors for adverse events included the use of anticoagulants, higher comorbidity scores, undergoing polypectomy, and detection of advanced neoplasia during colonoscopy. Dr. Lee emphasized, “The decision to perform colonoscopy surveillance after age 75 should be individualized based on patient preference, prior findings, procedure quality, comorbidities, and medication use, rather than age alone.” This statement underscores the necessity of personalized medical approaches in the aging population.

Despite its valuable insights, the study's findings may not be generalizable due to the specific demographic of insured individuals with access to comprehensive care. Moreover, it lacked a non-colonoscopy comparison group which could complicate attributing adverse events directly to the procedure itself. Notably, the study received support from the National Cancer Institute-funded Population-based Research to Optimize the Screening Process consortium, and the authors reported no conflicts of interest.

The implications of this study are significant as they could influence clinical decisions regarding the continuation of surveillance colonoscopy in older adults, a population often at increased risk for complications due to age-related comorbidities. As healthcare providers weigh the benefits of early cancer detection against the risks of potential adverse events, this research provides critical data to guide future practices and improve patient outcomes in the context of colorectal health.