Older adults are comfortable with nonbeneficial screening

Despite the growing recognition that older adults are undergoing cancer screening even when they are unlikely to benefit from such testing and would incur risks from the process, many such patients have never discussed stopping screening with their health care providers or have considered stopping on their own, indicated a recent study.        

Alexia M. Torke, MD, MS, of the Indiana University Center for Aging Research in Indianapolis, Indiana, and her fellow researchers described in JAMA Internal Medicine their interviews with 33 adults, age 63 to 91 years (median age 76 years), presenting to a senior health center. The respondents largely viewed undergoing screening as a moral obligation. For example, one woman felt that screening cessation would be equivalent to her taking her own life, which she said would be a sin.

Screening was also equated directly with health and life: The desire to live longer was given as a reason to pursue screening. Other reasons included, but were not limited to, the desire to prepare for the end of life, the desire to have treatment as soon as possible if cancer were in fact discovered, and the desire for peace of mind.

Many of the participants said that they viewed continued screening as a habit or custom that did not require any decision, whereas discontinuing the practice would require a major decision. Participants were skeptical about the role of statistics and the recommendations of government panels in screening decisions, but were more favorable toward stopping because of the balance of risks and benefits, complications, or test burdens. Nevertheless, some of the interviewees expressed being upset when their physician recommended that they stop undergoing screening, and some said they might lose trust in a physician who gave such advice.

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