Cancer rates go up with age, but more experts are suggesting that older people might be better off without regular screening for the disease.
That position is supported by the latest data suggesting that while early detection of cancer benefits younger people by giving them a chance to treat tumors and improve their prognosis, the same isn’t true for the elderly. They are more likely to die of other conditions like heart disease, and treating small cancers, some of which may be slow growing, that would never become an issue during the patient’s lifetime could lead to unneeded physical and mental complications.
For example, the U.S. Preventive Services Task Force recommends that patients older than 75 stop screening for colorectal cancer and women should only get mammograms every other year from age 50 to 74.
But many professional organizations continue to advise patients to get cancer screening throughout their lifetimes; the American Cancer Society recommends that women get mammograms every year once they turn 40 for as long as they are in good health and that men and women get regular colon screening after age 50. So researchers from the National Cancer Institute studied Medicare data from more than 400,700 elderly patients without cancer to determine if the benefits of regular screening still outweighed the risks. They estimated life expectancy for all of the participants, factoring in other chronic conditions.
They discovered that the patients who had more comorbidities also had shorter life expectancies compared with patients who were healthy — not a surprise since the burden of chronic diseases shortens life span. That means that these patients may be more likely to die of reasons other than cancer. Detecting the first signs of tumors in these individuals may not significantly improve their quality of life or extend their survival, so the authors suggesting factoring in such chronic diseases before advising patients on cancer screening. So a 75-year-old with few comorbidities may actually benefit from continued mammogram and colon-cancer screening, for instance, while a similarly aged individual with heart disease, diabetes and Parkinson’s disease may not benefit as much, and could skip the routine cancer checks.
Cancer screening, then, shouldn’t strictly be guided by age, the researchers argue, but instead should be more individualized to reflect each patient’s particular risk from the disease.
MORE: The Screening Dilemma