When Should We Stop Screening for Cancer?
While clinical screening for cervical and colorectal cancers in middle-aged Americans is standard practice that is generally agreed to improve health outcomes, screening for these cancers in the elderly has been more controversial. “The potential benefits of early detection with cancer screening decline with age,” said Dr. Robin Yabroff, an epidemiologist at the National Cancer Institute, in an email to Clinical Informatics News, “yet the potential harms, including complications from follow-up testing, do not.” Because the benefits from early detection of cancer may not be felt for years after discovery, elderly patients, whose prior life expectancy is lower, cannot confidently expect improved rates of survival even if a screening does detect cancer in its early stages. In the worst case, an elderly patient may be exposed to aggressive cancer treatments that reduce quality of life without improving life expectancy. For these reasons, the U.S. Preventive Services Task Force recommends that screening be discontinued at age 75 for colorectal cancer, and at age 65 for cervical cancer.
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