Overscreening was higher for women who live in or near cities. Researchers offer several reasons this may be. First, women who live in more rural areas may have longer and more trusting relationships with their healthcare providers, allowing for conversations about stopping cancer screenings. Second, rural women may have less access to screening facilities, reducing the number overscreened. Third, women who live in or near cities may receive automated screening reminders from more technologically-advanced healthcare facilities. Lastly, beliefs about cancer differ between rural and city populations. Those who live in or near a city may be more open to screening. Why men do not have the same overscreening difference is not known.
Preventing screenings that are not recommended is challenging, said the researchers. One reason is that life expectancy estimates are not always accurate. Another reason is that doctors and patients may not be comfortable discussing life expectancy and using it to make medical decisions. A third reason is that the healthcare system often encourages screening. A fourth reason is that awareness campaigns often do not highlight that screenings are not recommended for all ages.
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"Guidelines for cancer screening must balance risks with benefits," the researchers reported. "Individuals with limited life expectancy can anticipate fewer benefits of cancer screening, particularly for colonoscopy."
This research helps inform the general healthcare system. Patients should discuss their individual health decisions, including cancer screening, with their healthcare providers.
Additional researchers are Siddhartha Roy, assistant professor of family and community medicine; Chan Shen, assistant professor of surgery; Joie Cooper, research project manager; Dr. Robert Lennon, associate professor of family and community medicine; Eugene Lengerich, professor public health sciences; Dr. Alan Adelman, Jeanne L. and Thomas L. Leaman, M.D., Professorship and vice chair for research, family and community medicine; Dr. William Curry, professor of family and community medicine; and Dr. Mack Ruffin IV, The Hershey Company Professorship and department chair, family and community medicine.
National Cancer Institute and American Cancer Society funded this research. Lengerich is supported by National Center for Advancing Translational Sciences through Penn State Clinical and Translational Science Institute.Back to HCB News