{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:53:36Z","timestamp":1791176016197,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The benefits and harms of screening colonoscopy after age 75 remain uncertain. Guidelines endorse individualized decisions given competing risks, but comparative data are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the TriNetX US Collaborative Network, adults aged 75\u201390\u2009years with a colorectal cancer screening encounter were matched 1:1 by colonoscopy within 3\u2009months. Outcomes were assessed at 30\u2009days, 1\u2009year, and 5\u2009years. Sensitivity analyses excluded pre\u2010index anemia and, separately, fecal abnormalities and alarm symptoms; subsequent colonoscopy was counted through 5\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Matched cohorts comprised 58\u2009315 pairs at 30\u2009days, 61\u2009497 at 1\u2009year, and 69\u2009821 at 5\u2009years. Colonoscopy increased polyp detection (HR 4.43 [95% CI 4.15\u20134.73] at 30\u2009days; 1.88 [1.82\u20131.95] at 5\u2009years) and colorectal cancer detection (4.56 [3.62\u20135.74]; 1.78 [1.59\u20131.98]; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.003). Five\u2010year all\u2010cause mortality was unchanged (HR 1.01 [0.97\u20131.05];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.741). Perforation rose at 5\u2009years (HR 1.29 [1.02\u20131.63];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033); gastrointestinal bleeding fell at 1\u2009year (HR 0.90 [0.84\u20130.97];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). After exclusion of pre\u2010index anemia (70\u2009399 pairs), 5\u2010year HRs remained 1.72 for polyps and 1.52 for cancer. In an indication\u2010restricted cohort also excluding fecal abnormalities, weight loss, abdominal pain, and change in bowel habit (54\u2009300 pairs), the 5\u2010year HRs were 1.59 and 1.32. Subsequent colonoscopy from day 31 to year 5 was not more frequent after index screening (5.8% vs. 6.2%; HR 0.93).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Screening colonoscopy improved polyp and cancer detection but did not reduce 5\u2010year all\u2010cause mortality. The late perforation signal was not explained by more subsequent or therapeutic colonoscopy. Decisions after age 75 should be individualized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70479","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:45:31Z","timestamp":1791175531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Screening Colonoscopy in Older Adults: A Large Propensity\u2010Matched Real\u2010World Cohort Study"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6583-5362","authenticated-orcid":false,"given":"Taha","family":"Shakarchi","sequence":"first","affiliation":[{"name":"Lahey Hospital and Medical Center  Burlington Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7051-7413","authenticated-orcid":false,"given":"Muneeb","family":"Khawar","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4829-8611","authenticated-orcid":false,"given":"Mohammad Azeem","family":"Malik","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9805-3306","authenticated-orcid":false,"given":"Anuhya","family":"Jamandlamudi","sequence":"additional","affiliation":[{"name":"Guntur Medical College  Guntur Andhra Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4202-3006","authenticated-orcid":false,"given":"Ihsan Noushad Karuppan","family":"Veettil","sequence":"additional","affiliation":[{"name":"Sree Narayana Institute of Medical Sciences  Ernakulam Kerala India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aqsa","family":"Komel","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4048-0316","authenticated-orcid":false,"given":"Mirza Muhammad Hadeed","family":"Khawar","sequence":"additional","affiliation":[{"name":"Services Institute of Medical Sciences  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6398-8378","authenticated-orcid":false,"given":"Naima","family":"Agha","sequence":"additional","affiliation":[{"name":"Foundation University Medical College  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8916-2031","authenticated-orcid":false,"given":"Muhammad","family":"Habib","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8514-1884","authenticated-orcid":false,"given":"Ishtiaq","family":"Ahmad","sequence":"additional","affiliation":[{"name":"University of Iowa Hospitals &amp; Clinics  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2468-3412","authenticated-orcid":false,"given":"Ban","family":"Al\u2010Abayechi","sequence":"additional","affiliation":[{"name":"Lahey Hospital and Medical Center  Burlington Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5428-9848","authenticated-orcid":false,"given":"Ahmed","family":"Al\u2010Khazraji","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"issue":"6","key":"e_1_2_13_2_1","first-page":"394","article-title":"Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"68","author":"Bray F.","year":"2018","journal-title":"CA: A Cancer Journal for Clinicians"},{"issue":"1","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1002\/ijc.31664","article-title":"Global Cancer Incidence in Older Adults, 2012 and 2035: A Population\u2010Based Study","volume":"144","author":"Pilleron S.","year":"2019","journal-title":"International Journal of Cancer"},{"issue":"1","key":"e_1_2_13_4_1","first-page":"12","article-title":"Cancer Statistics, 2024","volume":"74","author":"Siegel R. 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