Table 1 Summary of the Educational Content of the Decision Aid by Section.

Introduction

• American Cancer Society (ACS) recommends individualized decision making for older adults age 75 and over.

• This decision aid will help you think about whether colorectal cancer screening is the right choice for you.

Information about Colon Cancer Screening

• Colorectal cancer screening tests look for colon cancer before you have symptoms.

Two Main Types of Tests that Screen for Colon Cancer

• Colonoscopy is a procedure that requires preparation and occurs at the doctor's office.

• Stool cards can be done at home and returned to the doctor's office.

Those with cards positive for blood will need to have a colonoscopy.

Treatments People Undergo if Colon Cancer is Found

• Most people with invasive colon cancer will need surgery.

• Some people may need chemotherapy after surgery.

Colon Cancer Screening Recommendations Are Different for Older Adults

• As adults get older they are more likely to encounter numerous health problems that could affect their life expectancy.

• We are not sure whether screening is beneficial for those 75 years and older.

• That is why the ACS recommends older adults decide about colorectal cancer screening for themselves.

Why do Older Adults Need to Decide for Themselves about Colon Cancer Screening?

• The chances of getting a serious illness go up with increased age. Older adults are also more likely to develop colon cancer.

Life expectancies for older adults vary with the number of serious health problems.

• In most cases colon cancer grows slowly. If someone develops colon cancer today he may not have any problems for 5-10 years.

• Colon cancer screening will not help all older people. A person's life expectancy can be influenced by their current health condition.

• Older adults must deal with competing causes of death. Other health problems may lead to death before colon cancer.

• There is uncertainty about who will benefit. No one can know how long any individual will live.

Magnitude of potential benefit from colon cancer screening

• One life is extended for every 1000 people who are screened.

Risks to Consider in Making Your Decision about Colon Cancer Screening

• Pictograph (Figure 1) compares the risk of dying from heart disease, stroke or colon cancer over 10 years.

• Pictograph (Figure 2) compares the risk of having a complication (bleeding, perforation or death) after the first 30 days of a colonoscopy.

Balancing the Benefits and Risks of Colonoscopy in People age 75 and Older

• Figure 3 compares how a person's health can influence the balance between the benefits and risks of colon cancer screening.