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Older patients might not benefit from cancer screenings

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Nearly half of seniors in the U.S. continue to receive regular cancer screenings to detect potential breast, prostate, colorectal and cervical cancers, regardless of its limited benefits, considerable costs, possible risks because of invasive procedures and the likelihood that they would die without the disease in nine years, two studies in JAMA Internal Medicine reveal.

The first study, Cancer Screening Rates in Individuals With Different Life Expectancies, involved data from the National Health Interview Survey from 2000-2010 and 27,404 participants who are 65 years and older.

Results showed that the participants with extremely high risk for mortality, 31 to 55 percent underwent recent screening for cancer, with screening for prostate cancer the most common at 55 percent.

Meanwhile, women who went through hysterectomy for benign purposes, 34 to 56 percent of them took a Papanicolaou screening in the past three years.

Nevertheless, there were fewer prostate and cervical cancer screenings in more recent years as opposed to year 2000.

Further, the researchers’ analysis indicated that cancer screening was similarly common to individuals whose life expectancy is less than five years.

“A substantial proportion of the US population with limited life expectancy received prostate, breast, cervical, and colorectal cancer screening that is unlikely to provide net benefit. These results suggest that overscreening is common in both men and women, which not only increases health care expenditure but can lead to net patient harm,” concludes the study.

In the second study, The Appropriateness of More Intensive Colonoscopy Screening Than Recommended in Medicare Beneficiaries: A Modeling Study, it was also discovered that many beneficiaries of Medicare go through more intensive colonoscopy screening than actually recommended.

A microsimulation modeling study of Medicare beneficiaries aged 65 year old was conducted. Those who have average risk for the colorectal cancer and average life expectancy who went through colonoscopy screening at 55 years with negative results were conducted.

Study showed that the more intensive screening of previously screened Medicare recipients than suggested only resulted in small increases in preventing CRC deaths and gaining life years. It likewise concluded that such move to help the recipients isn’t only inefficient from a social perspective but also unfavorable to those being screened; reason why the practice is actively discouraged by the researchers.

“It is particularly important to question screening strategies for older persons. Patients with a shorter life expectancy have less time to develop clinically significant cancers after a screening test and are more likely to die from noncancer health problems after a cancer diagnosis. In addition, older persons face a higher risk of complications from procedures such as screening colonoscopy,” says Carry P. Gross, MD, in an invited commentary.

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