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Review
. 2020 Aug 15;22(11):108.
doi: 10.1007/s11912-020-00968-x.

Cancer Screening Among Older Adults: a Geriatrician's Perspective on Breast, Cervical, Colon, Prostate, and Lung Cancer Screening

Ashwin A Kotwal  1   2 , Louise C Walter  3   4
Affiliations
Review

Cancer Screening Among Older Adults: a Geriatrician's Perspective on Breast, Cervical, Colon, Prostate, and Lung Cancer Screening

Ashwin A Kotwal et al. Curr Oncol Rep. .

Abstract

Purpose of review: We summarize the evidence of benefits, harms, and tools to assist in individualized decisions among older adults in screening for breast, prostate, colon, lung, and cervical cancer.

Recent findings: The benefits of cancer screening in older adults remain unclear due to minimal inclusion of adults > 75 years old in most randomized controlled trials. Indirect evidence suggests that the benefits of screening seen in younger adults (< 70 years old) can be extrapolated to older adults when they have an estimated life expectancy of at least 10 years. However, older adults, especially those with limited life expectancy, may be at increased risk for experiencing harms of screening, including overdiagnosis of clinically unimportant diseases, complications from diagnostic procedures, and distress after false positive test results. We provide a framework to integrate key factors such as health status, risks and benefits of specific tests, and patient preferences to guide clinicians in cancer screening decisions in older adults.

Keywords: Cancer screening; Colon cancer; Lung cancer; Mammogram; Older adults; PSA test.

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Figures

Figure.
Figure.
Upper, Middle, and Lower Quartiles of Life Expectancy for Men and Women at Selected Ages Based on 2017 United States Life Tables [7]
Figure.
Figure.
Upper, Middle, and Lower Quartiles of Life Expectancy for Men and Women at Selected Ages Based on 2017 United States Life Tables [7]
See this image and copyright information in PMC

References

    1. Kotwal AA, Schonberg MA. Cancer Screening in the Elderly: A Review of Breast, Colorectal, Lung, and Prostate Cancer Screening. The Cancer Journal. 2017;23(4):246–53. - PMC - PubMed
    1. Welch HG, Black WC. Overdiagnosis in cancer. Journal of the National Cancer Institute. 2010;102(9):605–13. - PubMed
    1. Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. Jama. 2001;285(21):2750–6. - PubMed
    1. Lee SJ, Leipzig RM, Walter LC. Incorporating lag time to benefit into prevention decisions for older adults. Jama. 2013;310(24):2609–10. - PMC - PubMed
    1. Lee SJ, Boscardin WJ, Stijacic-Cenzer I, Conell-Price J, O’Brien S, Walter LC. Time lag to benefit after screening for breast and colorectal cancer: meta-analysis of survival data from the United States, Sweden, United Kingdom, and Denmark. Bmj. 2013;346:e8441. - PMC - PubMed