Older Americans may be receiving cancer screenings not recommended by the U.S. Preventive Services Task Force, according to Penn State College of Medicine researchers.
The task force recommends routine screening for colorectal, cervical and breast cancers. These recommendations end for people at upper ages or who develop a condition that decreases their life expectancy. A routine screening above the recommended age is called overscreening.
"There are two reasons why people should stop screening for cancer," Jennifer Moss, assistant professor of family and community medicine and public health sciences, said. "First, when they 'age-out' of the recommended screening age, or second, when their life expectancy is too low. As with any clinical procedure, there are risks from the cancer screening tests. These risks are even higher for people who have aged-out or who have a low life expectancy."
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To determine the extent of overscreening nationally, the researchers analyzed data from the Center for Disease Control and Prevention's 2018 Behavioral Risk Factor Surveillance System. This survey collects data about a variety of health behaviors, including cancer screening. In total, researchers reviewed data for 20,937 men and 34,244 women for colorectal cancer, 82,811 women for cervical cancer and 38,356 women for breast cancer. Researchers identified overscreened patients as those over age 75 for colorectal cancer screening, and women over 65 for cervical and over 75 for breast cancer screenings. The researchers also determined patient location and whether the patient lived in or near a city.
"We can never exactly know a person's life expectancy, but my co-authors and I used a scientifically-accepted index to calculate estimated risk of death over the next 10 years," Moss said. "We hypothesized that people who are older or who have lower life expectancies would be less likely to report having received their cancer screenings recently, but we didn't see strong evidence of this. This pattern shows us that too many people are getting screened after a point when the screening is probably not going to provide benefit and may cause harm."
Researchers found overscreening of 59.3% of men and 56.2% of women for colorectal cancer; 45.8% of women for breast cancer and 73% of women for breast cancer. Research results appear in the journal JAMA Network Open.
"This pattern emphasizes the need for additional research to identify risks and benefits of screening in older adults and determine who may benefit from screening after the recommended upper-age limits," the researchers reported.