For middle-aged and older adults, each year can feel as if it comes with a new set of medical tests, appointments and precautions. As we age, our likelihood to develop certain cancers rises, which explains the sudden increase in prescribed screenings starting in your 40s and 50s. But is it possible that older adults could be receiving too many screenings? David Paul, MD, a medical oncologist at Banner MD Anderson Cancer Center at Banner – University Medical Center Phoenix explains the important factors to take into consideration.
Should you be getting screened?
You’re probably aware that cancer screenings are recommended starting at certain ages. For example, Banner MD Anderson recommends that men and women get colorectal cancer screenings every 10 years starting at age 50. But did you know that the recommendation may end when you reach 75 years old? It is estimated that 45% of older adults in the United States are undergoing cancer screenings for colorectal, cervical or breast cancer beyond the recommended age limit.
“Cancer risk is unique to each individual,” said. Dr. Paul. “Although we have benchmarks for age, there are many factors that go into deciding if it’s time to begin or cease your cancer screenings.” He explained that family history and existing health issues are also major factors in predicting our risk. For some people, getting screened after the age limit might be recommended. It’s a conversation that you should be having with your doctor.
What risks come with too many screenings?
It may feel counterintuitive to just stop screenings altogether. Consider these important factors:
Risks of screening
Cancer screenings are relatively safe and well worth the risk for younger, healthy patients. But the process of getting screened can be riskier for seniors of advanced age. Dr. Paul explained that some screenings, such as colonoscopies, could include anesthesia which may cause unnecessary damage to our organs. While these factors are well worth the risk at younger ages, you and your doctor should discuss whether they are worth the possibility for complications as you get older.
Over-diagnosing and false positives
When signs of cancer are found, you and your team of doctors will want to do everything possible to eliminate or control it. Over-diagnosing is when asymptomatic cancer is found, but that cancer poses little risk to the patient because it is growing very slowly. A biopsy of a false positive could lead to unnecessary complications. In older adults, the process of diagnosing and treating the cancer may prove to be more harmful than the cancer itself.
Quality of life
Life expectancy is a sensitive topic, that should be discussed openly and honestly with your doctor. Like the previous factor, preserving quality of life may be a priority over attacking cancer with aggressive treatments. Many people die with undiagnosed cancer, not from it. In these cases, treatment may only make your final years less comfortable.
What to do
Dr. Paul encouraged older patients and doctors to discuss all factors of your health and lifestyle. As you meet regularly with your doctor, don’t be afraid to ask questions and explain your wishes. “These conversations are not about rationing care or throwing in the towel,” said Dr. Paul. “It should be an open and transparent discussion about your risks and how to make the rest of your life as comfortable and long as possible.”
Schedule a visit with your primary care physician to discuss how often you should be getting screened.
