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Background/Aims Colonoscopy (CSP) is recommended for colorectal (CRC) screening worldwide. However, evidence for the effectiveness of CSP in the elderly over 80 years is limited. We estimated whether CSP decrease the risk of CRC in the elderly population. Methods Between January 2006 and December 2007, data for subjects aged 70 years and older who underwent CSP claimed were collected from National Health Insurance Service (NHIS). CSP subjects cohort was matched to non-CSP (N-CSP) subjects who did not undergo CSP. The risk of developing CRC was estimated by the incident new cases from January 2009 to December 2014 based on the link of National CRC Registry to NHIS database. Compared with N-CSP cohort, hazard ratios (HRs) were obtained via conditional logistic regression analysis to estimate the risk of CRC in CSP cohort (diagnostic and therapeutic CSP) by ages at which CSP was performed. Results A total of 2,673,651 subjects were included (CSP cohort: 114,799 and N-CSP cohort: 2,558,852). Compared to matched age groups in N-CSP cohorts, the HRs for developing CRC by ages of 70-74, 75-79, and >80 years were 0.393, 0.490, and 0.652 in diagnostic CSP group (p<0.001, p<0.001, and p=0.002), respectively. Also, the HRs for developing CRC by ages of 70-74 and 75-79 were 0.635 and 0.636 (p<0.001 and p<0.001). Of note, however, CRC risk was not decreased by therapeutic CSP in the elderly over 80 years of age (HR, 1.023; p=0.909). Conclusions Diagnostic CSP is associated with a reduction in CRC development among the elderly over 70 years or older. However, therapeutic CSP did not prevent the incidence of CRC in the very elderly over 80 years, suggesting a differentiated CRC screening guideline for these very elderly persons. [ABSTRACT FROM AUTHOR]

Aim: To investigate the electrolyte changes between 2-L polyethylene glycol with ascorbic acid 20 g (PEG-Asc) and 4-L PEG solutions., Methods: From August 2012 to February 2013, a total of 226 patients were enrolled at four tertiary hospitals. All patients were randomly allocated to a PEG-Asc group or a 4-L PEG. Before colonoscopy, patients completed a questionnaire to assess bowel preparation-related symptoms, satisfaction, and willingness. Endoscopists assessed the bowel preparation using the Boston Bowel Preparation Scale (BBPS). In addition, blood tests, including serum electrolytes, serum osmolarity, and urine osmolarity were evaluated both before and after the procedure., Results: A total of 226 patients were analyzed. BBPS scores were similar and the adequate bowel preparation rate (BBPS ≥ 6) was not different between the two groups (PEG-Asc vs 4-L PEG, 73.2% vs 76.3%, P = 0.760). Bowel preparation-related symptoms also were not different between the two groups. The taste of PEG-Asc was better (41.1% vs 16.7%, P < 0.001), and the willingness to undergo repeated bowel preparation was higher in the PEG-Asc group (73.2% vs 59.3%, P = 0.027) than in 4-L PEG. There were no significant changes in serum electrolytes in either group., Conclusion: In this multicenter trial, bowel preparation with PEG-Asc was better than 4-L PEG in terms of patient satisfaction, with similar degrees of bowel preparation and electrolyte changes.