When to stop screening: a review of breast, gynecologic, and colorectal cancer screening in women over age 65.
Because age alone is not an indicator of health, there is no clear consensus among the various cancer screening guidelines on when to stop cancer screening. For breast, cervical, and colorectal cancer, there are recommended screening tests, while, for other gynecologic cancers, there are not. When discussing with older women patients when to stop cancer screening, we encourage practitioners to review the goals of the screening test, assess the health and functional status of the patient, and discuss her values and health goals. To facilitate this discussion, we review proposed frameworks for determining when to screen older patients for cancer. We also review the concepts of "well" and "frail" older adults. Finally, we review the current screening recommendations for breast, gynecological, and colorectal cancers, and the reasoning behind them, from the United States Preventative Screening Task Force, the American Cancer Society, the American College of Obstetricians and Gynecologists, and the American Geriatric Society.
Bernstein
Rebecca
R
Jefferson Medical College, Philadelphia, PA 19107, USA.
DeJoseph
Daniel
D
Buchanan
Edward M
EM
D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003142:Communication; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening; D010817:Physician-Patient Relations; D012307:Risk Factors; D014481:United States / Q000453:epidemiology