What Should We Recommend for Colorectal Cancer Screening in Adults Aged 75 and Older?

Round 1

Reviewer 1 Report

The Commentary article authored by Dr Arora et al addresses the guidelines for colorectal cancer screening in adults aged 75 and older.

The Authors specify that these guidelines are based on the absence of demonstrated benefit of screening due to systematic exclusion of older adults and the lack of available data. The assumption of the absence of benefit is also related to reduced life expectancy. Nevertheless, it is becoming increasingly clear that individual’s health status should be appreciated as multidimensional, including physical, functional and cognitive elements, rather than chronological age. Non-invasive screening such as fecal immunochemical testing can be easily performed by older individuals. Furthermore, the progresses in the therapeutic approaches have considerably decreased the risks of morbidity for older adults. Thus, the Authors suggest to apply new guidelines based on an individualized screening specific for elderly people, taking into account for instance the overall health status.

The manuscript is pleasant to read and comprehensible. The topic is of importance considering the longer and healthier living, and the increasing number of older adults in industrialized countries. Thus, I consider that the manuscript is worth publishing in Current Oncology.

Author Response

Thank you for your positive comments

Reviewer 2 Report

Apart from the fact that by preventing colorectal cancer we reduce health costs and allow enjoying a person his family, and his life as well, we are not the ones who will condemn a patient to suffer or even die while we could have caught it. Thank you very much for this very interesting work of yours and I suggest to be published without any changes.

Author Response

Thank you for your positive comments

Reviewer 3 Report

The commentary on screening for patients older than 75 years is well written, cohesive and aims at answering one of the important questions regarding screening. Even though it is a highly educated opinion, not based on direct data and research, it has important merits and it should be published in order to influence policymakers and it should be seen by guideline developers. I have no further comments.

Author Response

Thank you for your positive comments