Addressing the Frequency of Cancer Screenings in Older Patients
The U.S. Preventive Services Task Force guidelines recommend against routine cancer screening, especially for cases of breast, cervical, colorectal and prostate cancer. However adults aged 75 and older are still undergoing regular cancer screenings. The report is published in the Archives of Internal Medicine and is part of the journal's Less is More series. This series' purpose is to educate healthcare professionals and patients alike in cutting costs, but having better service at the same time.
The authors attempt to highlight background information relevant to the article by stating, “In the U.S., the number of adults 65 years or older, currently at 36.8 million, is expected to double by the year 2030. Providing high-quality care to this growing population while attempting to limit costs will pose a significant challenge. While a great deal is known about cancer screening behaviors and trends in young and middle-aged adults, less is known about screening behaviors in older adults from different racial backgrounds.”
Lead author Keith Bellizzi, Ph.D., M.P.H, of the University of Connecticut, and colleagues analyzed data from the National Health Interview Survey. This annual in-person nationwide survey is used to track health trends in U.S. citizens and to estimate the prevalence of cancer screening among older, racially diverse adults. The study included 49,575 participants, 1,697 of whom were 75 to 79 years of age and 2,376 who were 80 years and older.
The result of the demographic analysis found that 62 percent of women aged 75 to 79 and 50 percent of women age 80 and older had a mammogram within the last two years. Amongst women age 75 to 79 and over 80, a pap test was administered to 53 percent and 38 percent, respectively. For men and women aged 75 to 79, 57 percent received screenings for colorectal cancer. Additionally, 57 percent of men 75 to 79 and 42 percent of men 80 and older received prostate cancer screenings.
Additional analysis found large differences in breast, colorectal, and prostate cancer screening amongst older adults. However, the authors discovered that these differences were accounted for by low education. Individuals with no high school diploma were dramatically less likely to receive screenings for breast, cervical, and prostate cancer, compared with adults older than 75 years with a college degree. Adults older than 75 years were also much more likely to receive breast, cervical, and prostate cancer screenings if a physician recommended the test.
The authors conclude, “A high percentage of older adults continue to be screened in the face of ambiguity of recommendations for this group. Prevalence results from this study can serve as a benchmark for progress as we move forward in the science of cancer screening in older, diverse adults.”
-Stuart Diamond
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