Cancer Screenings for Seniors: An Ongoing Controversy

Blog  |  February 16, 2017

As people grow older, certain medical conditions are likely to develop. This is especially true of cancer. Cancer is the second leading cause of death among those 65 years and older, and its occurrence increases with age.

Screening means checking your body for cancer before you have symptoms. Malignancies respond to treatment more effectively when discovered and diagnosed in the early stages of development, which is why you may opt to get screened regularly for various types of cancer. Here are the typical screening recommendations for seniors age 65 or older, and Medicare may cover them:

FOR MEN:

Prostate Cancer Testing
Overall health status – not just age – is important when deciding about prostate cancer testing. Men who can expect to live at least 10 more years should talk with a doctor about the uncertainties, risks, and potential benefits of testing so they can decide if they want to be tested.

FOR WOMEN:

Breast Cancer Testing
If there are any changes in how breasts appear or feel, report it to a doctor immediately. Get a mammogram every two years, or choose to get one every year. Be sure to understand the pros and cons of breast cancer screening. When deciding how often to screen for breast cancer, consider whether you are at higher than average risk for breast cancer. If you are, talk to a health care provider about whether you need to get other tests done along with your mammograms.

Cervical Cancer Testing
For women age 65 or older, many medical professionals believe that no further testing is needed if you’ve had regular cervical cancer testing with normal results during the past 10 years. No testing is needed after a hysterectomy that removed the uterus and cervix, if it was done for reasons not related to cervical cancer.
Women with a history of a serious cervical pre-cancer should continue testing for 20 years after that diagnosis.

FOR BOTH GENDERS:

Colon Cancer Testing
Testing is recommended, and there are many testing options. Talk with a doctor about which tests are best for you and how often testing should be done.

Lung Cancer Testing
If you have a history of smoking, consult with a health care provider about whether you should get an annual
low-dose CT scan to screen for early lung cancer. Screening may benefit you if you are an active or former smoker (quit within the past 15 years), have no signs of lung cancer, and have had a single pack of cigarettes per day per year, or its equivalent. For example, one pack per day for 30 years is equal to two packs per day for 15 years. Discuss the benefits, limitations, and risks of screening with a medical professional before testing is done.

When to Stop Screenings: The Debate Among Doctors and Specialists

There are few clinical trials that include older patients, creating a lack of data about the effectiveness and possible harms of cancer screening in the senior population. This results in a variation in recommendations, especially in regard to when it’s time to stop screening. The problem is that guidelines are too often based on younger patients, and do not always consider individual variations in life expectancy, comorbid conditions, functional status, or personal preference. That said, medical societies and other expert groups may recommend:

• Stop routine Pap smears to screen for cervical cancer at age 65, if they have been negative in the past.
• Stop routine screening mammography for women at average risk of breast cancer after age 75.
• Stop screening colonoscopies for adults at average risk of colorectal cancer at age 75.
• Stop routine screening usinga blood test that measures the amount of prostate-specific antigen (PSA) in
  the blood, when there is average risk at any age. PSA is a protein produced by the prostate gland.

Many doctors ignore these guidelines – again, because cancer screening recommendations based on age alone can be too arbitrary. A frail 75-year-old with heart disease and diabetes is different from a robust 75-year-old who exercises every day, so many experts suggest considering a person’s life expectancy. If it is less than
10 years, cancer screening is unlikely to improve a person’s survival or quality of life, and the risks of screening could be greater than the benefits. However, since life expectancy can be difficult to predict, doctors hesitate to halt screenings for many of their patients.

A decision about cancer screening should be mutually agreed upon by you and your doctor. Due to differing approaches within the medical community, you and your doctor should discuss the pros and cons when it comes to cancer screening. Getting screening tests regularly may find cancers early, when treatment is most likely to work –  but it is also important to be well informed about the risks of any test, and about what will happen if a test suggests there may be cancer that won’t shorten your life.

Comfort Keepers^® can help. Our caregivers can help establish a daily routine with your loved one that promotes good health and independent living. We can also make sure that he or she has transportation to and from medical appointments. Call your local office today to find out about all of the services that we can provide.

References:

A Place for Mom. “Cancer Screening Timelines for Boomers and Seniors” by Dana Larsen. Web. 2016.

Harvard Health Publications.“Many Seniors Get Unnecessary and Potentially Harmful Cancer Tests” by
Howard LeWine, M.D. Web. 2014.

American Cancer Society. “Cancer Screening Guidelines by Age.” Web. 2016.

Centers for Disease Control and Prevention (CDC). “Cancer Prevention and Control.” Web. 2016.

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