Different Strokes for Different Folks that is all you can say about this age group by and large its palliative care but at times you have very "well preserved" and quite functionally intact so any invasive diagnostic and therapeutic intervention needs to be done in the same context ! In any case it is important to establish the diagnosis first and then deal with the therapeutic options on case to case basis

Team work with patients and family members and optional for colonoscopy

Discussion with shared decision making between physician, patient and family members is critical

Patient education and family education is very important for better education to start to process earlier to help prevent colon cancer for a positive outcome and greater prevention.

not to be harsh but at age 90> the life expectancy is low and the need for colonoscopy without prior disease hx or abnormal colonoscopy in the past, I think isn't really necessary in this age group

now if the above is true prior hx of cancer or abnormal colonoscopy in past then definitely other co-morbid conditions, pts functional lifestyle all should play a role when considering yay or nay for this procedure

most of this age group is on blood thinners so to take them off for a procedure like this increases the risk of them dying or gaining severe disability from something more common like heart attack or stroke

Looking at other comorbidities and functionality is important

Colonoscopy as many invasive procedures should be avoided in nonagenarian. Thorough discussion regarding goals of care should be done prior to undergoing procedure. In most cases patients would have living wills and advanced directive in place.

I stopped ordering them after 75. I usually don't do a test that I'm probably not going to act on the results.

One must always consider impact on quality of life with the elderly. What is risk of sedation / procedure and what could change based on result ? Patient should be an active part of decision -making process

Colonoscopy is now recommended age is 45 but many patients refuse to do it due to preparation. I suggest colon guard which is recommended

Patient education and in some cases family education is very important for a positive outcome and run things smoothly.

is not only age most important other co morbidities quality of life pts wishes lengthy conversation with family and patient is very helpful i would asked them if we find something are we going for surgery / other treatment

Risk to benefit ratio should be shared with the patient and caregivers before pursuing these procedures.

colonoscopy is determined by age and also family hx and personal hx as well as their colonoscopy findings in the past, cologuard can also be very helpful to do a non invasive test for these patients

Colonoscopies at this age really need to be determined on a case-by-case basis. I would venture that the majority of these type of cases are only conducted when outcome may improve possible quality of life, palliative benefit, or clear guidance to improve patient's longevity. Certainly, routine preventative screenings should not continued.

If a patient has an anticipated life expectancy of less than 10 years, preventive screenings including Mammograms; colon cancer screenings are going to yield no benefit

In the absence of clinical suspicion, screening for colon cancer past 85 would seem to have minimal expected benefit and there are probably better uses of resources.

In nonagenarians (≥90 years), chronologic age alone should not be the deciding factor for colonoscopy. Instead, decisions should be driven by biologic age, comorbidity burden, frailty status, life expectancy, and the likelihood that findings will change management.