To the Editor A recent study provided valuable competing risk data for surveillance decisions in adults aged 75 years or older with prior colonoscopy. In their cohort, 10-year colorectal cancer incidence was higher among individuals with prior adenoma than among those without adenoma, but the absolute difference was small (1.1% vs 0.7%). Colorectal cancer mortality was similarly low, whereas noncolorectal cancer death was approximately 48%, and increased to 82% among those with severe frailty. The accompanying Editorial appropriately framed these findings as a challenge to reflexive surveillance in late life.