Caregivers may want to nix cancer screening for patients with dementia

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Many people caring for a family member with dementia want to put an end to screening the person for cancer as the dementia progresses, and are relieved when health care providers bring up the topic, according to the findings of a small focus-group study.

A total of 32 caregivers from Alzheimer's Association support groups for family members of persons with dementia took part in focus groups arranged by Alexia M. Torke, MD, MS, of the Indiana University Center for Aging Research in Indianapolis, Indiana, and colleagues. The researchers sought to understand the perspectives of family caregivers in terms of stopping cancer-screening tests for the dementia patients and to identify opportunities for reducing harmful or unnecessary screening.

After analyzing the focus-group transcripts, Torke's team reported in the Journal of the American Geriatrics Society that the caregivers had four areas of concern regarding cancer screening for relatives with dementia: quality versus quantity of life, burdens that screening placed on the patients and on the caregivers themselves, how to end screening, and variability of physician expertise on the risks and benefits of cancer screening for this patient population.

Many of the participating caregivers described having to intervene to stop unnecessary or harmful cancer screening of the person with dementia. Some respondents said they met resistance when they advocated for stopping screening. The transcripts indicated that physicians varied widely in their knowledge of dementia care and willingness to consider stopping cancer screening for a person with dementia.

Torke and associates concluded that as a person's dementia progresses, many family caregivers wish to stop cancer screening for that patient and are relieved when the clinician introduces this possibility. The investigators noted that caregivers are open to discussions of screening cessation that focus on quality of life, burdens, and benefits, and that interventions are needed to increase such discussions between caregivers and clinicians. Additionally, steps are needed to raise clinician awareness of the need to reconsider cancer screening in persons with dementia.

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