Can screening older patients for cancer save lives?
Cancer screening of the elderly is warranted for those cancers for which early detection and treatment improve life expectancy. There is excellent evidence to include screening for breast cancer with clinical examination and mammography for elderly women. There is also reasonable evidence to screen for cervical cancer with PAP testing in elderly women who were previously unscreened, although there is no evidence to support continuing the practice in women who have had consecutive normal PAP tests. No evidence supports or refutes screening programs for colon, prostate, skin, or oral cancer in the elderly. The authors recommend including screening for colon and prostate cancer in the routine examination of office patients. The potential benefit for the rare patient in whom an early stage cancer is discovered and treated is large and worth both the physician's and patient's time and effort. The authors recommend screening only patients deemed to be at high risk for skin and oral cancer. The main factor favoring continued screening in the elderly is the burden of suffering and the pronounced increased incidence of the disease in old age. Lastly, the authors recommend against routine screening for lung cancer in the elderly.
Oddone
E Z
EZ
Division of General Internal Medicine, Duke University Medical Center, Durham, North Carolina.
Feussner
J R
JR
Cohen
H J
HJ
D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D011237:Predictive Value of Tests; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control