Cancer screenings are an important part of your preventive health. Screenings can spot disease early, often before symptoms appear. That can sometimes make cancer easier to treat and improve the chance for recovery.
But as you get older, routine screenings may not always offer the same benefit. So how do you know when it’s time to stop screening for cancer? A 2023 National Poll on Healthy Aging found that many older adults are unsure when to stop screening.
That uncertainty may be because there are no hard-and-fast rules. The answer depends on your overall health, life expectancy and personal risk factors, not just your age. When to stop cancer screenings is different for everyone.
Why do cancer screenings matter?
“The point of cancer screenings is to target people who are more prone for a certain type of cancer at their age,” said David Paul, MD, an oncologist with Banner MD Anderson Cancer Center at Banner - University Medical Center Phoenix.
Screening tests are designed to catch cancer early, when it’s easier to treat. Common screening tools include:
- Mammograms for breast cancer
- Colonoscopy or stool-based tests for colon cancer
- Low-dose CT scans for lung cancer, especially in long-term smokers
- Pap tests for cervical cancer
- PSA blood tests for prostate cancer
Being screened for cancer could save your life. But every test comes with risks, especially as you get older or develop other health conditions.
When could screening do more harm than good?
It might seem like screening for cancer is always a good idea. But as you get older, the benefits may decrease, while risks increase. Possible downsides include:
- False positives, where you may face unnecessary testing, stress and the risk of complications from biopsies
- Complications from invasive screening procedures that require anesthesia, like colonoscopy
- Finding slow-growing cancers that won’t cause problems for the rest of your life
- Emotional and physical strain from unneeded treatments
Some national guidelines, such as those from the United States Preventive Services Task Force (USPSTF) and the Centers for Disease Control and Prevention (CDC), use age cutoffs or life expectancy estimates to suggest when to stop certain screenings. For example, some recommend stopping colon cancer screening at age 75 or lung cancer screening at 80.
But health decisions aren’t always that simple. And the healthy aging poll found that some adults age 50 to 80 disagree with using life expectancy to guide these decisions.
What does a more personalized approach to screening look like?
At Banner MD Anderson, we don’t just look at the year you were born. We look at your functional age, overall health and personal goals.
Our experts consider:
- Whether you have had cancer
- Your family history of cancer
- Other health conditions, such as heart disease or memory loss
- The medications you take and the risk of complications
- How independent you are and what day-to-day activities you do
- Whether you’re likely to live long enough to benefit from continued screening
Our goal is to help you make screening decisions that support your quality of life, not just follow a checklist. We want to help you avoid screenings that could be harmful or stressful, if they aren’t going to help.
“We need to be cautious not to cause harm as you get into the 75-plus age range but not discount that people could have another 15 or 20 years of life ahead of them that we want to protect,” Dr. Paul said.
Which older adults could benefit from screening?
The right screening plan depends on your individual health, not just your age. “On the negative side, if someone is in an assisted living facility or has serious health problems, why screen them for cancer if they wouldn’t be able to withstand the treatment they would need,” Dr. Paul said.
“And on the positive side, you could have someone 80 years old or beyond who’s strong, active and independent. That person would probably want to keep getting their screening tests,” Dr. Paul said. “Some people just age so well that it makes sense for them to continue screening.”
Screening may still make sense if you:
- Are in good health and active
- Have a long life expectancy
- Have a strong family history of cancer
- Are a long-term smoker
- Haven’t had regular screenings before
- Want to stay on top of your health with your doctor’s guidance
While everyone’s decision-making process is different, Dr. Paul uses a five-year rule of thumb. If there’s nothing else threatening someone’s health in the next five years, he generally recommends continuing screening.
Keep in mind that each type of cancer screening is different. For example, you and your health care provider may decide you should stop having colonoscopies as you get older, since they have a higher risk of complications. But it may make sense to continue having mammograms.
What questions should you ask your health care provider?
If you’re wondering whether to continue cancer screenings, bring these questions to your next visit:
- Should I still be screened for this type of cancer?
- How common is this type of cancer in people like me?
- What are the risks and benefits of screening for someone my age, gender and health?
- If we don’t screen, what’s the alternative?
- How might this screening affect my quality of life?
- Are there other ways to monitor my health?
- Could we take a watch-and-wait approach instead?
- If the test finds cancer, what would the treatment options be?
Having open conversations with your provider can help you make informed choices that line up with your plans and goals. “These should be transparent discussions about your risks and how to make the rest of your life as comfortable and as long as possible.” Dr. Paul said.
How can Banner MD Anderson help?
At Banner MD Anderson, we support smart, evidence-based decisions about screening and prevention. We focus on:
- Your full medical picture
- The latest research and national guidelines
- A care plan built around your personal goals
Reach out to an expert for help with your cancer screening decisions. We’re here to help you weigh the pros and cons and feel confident about your path forward.
