Older adults may undergo cancer screening more frequently than necessary

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Routine Cancer Screening Common in Elderly Aged 75 Up
Routine Cancer Screening Common in Elderly Aged 75 Up

HealthDay News -- Many adults aged 75 years or older report that their health-care providers routinely recommend cancer screening despite uncertainty about the value of screening in this age group, data from a nationally representative survey indicate.

Among 1,697 adults aged 75 to 79 years who participated in the National Health Interview Survey, 57% were screened for colorectal cancer, 63% were screened for breast cancer, 53% were screened for cervical cancer and 56% were screened for prostate cancer, Keith M. Bellizzi, PhD, MPH, from the University of Connecticut in Storrs, and colleagues reported in the Archives of Internal Medicine.

Cancer screening rates among the 2,376 participants aged 80 years or older varied from a low of 38% for cervical cancer to a high of 50% for breast cancer, data indicated.

After analyzing screening behaviors in relation to the U.S. Preventive Services Task Force screening recommendations for breast, cervical, colorectal and prostate cancers, the researchers found that the largest screening predictor was a physician's recommendation for a specific test.

Patients aged 75 years and older were significantly more likely to have been screened for breast (odds ratio=21.4; 95% CI:16-28.6), cervical (OR=42.1; 95% CI: 25.4-69.8), colorectal (OR=67.7; 95% CI: 50.5-90.9), and prostate cancers (OR=44.1; 95% CI: 20.5-94.9) if they recalled that a physician suggested that they have the test, and more than 50% reported that their physician continued to recommend screening.

In unadjusted analyses, screening prevalence rates varied according to race/ethnicity, but on multivariate regression analysis, these differences were accounted for by low education attainment.

Respondents with less than a high school education were less likely to be screened for breast (OR=0.4; 95% CI 0.3 to 0.7), cervical (OR=0.4; 95% CI:0.2-0.8), colorectal (OR=0.5; 95% CI: 0.3-0.8) and prostate (OR=0.5; 95% CI:0.3-0.8) cancers compared to those with a college degree.

Older adults are the fastest growing segment of the population and place the greatest demands on the healthcare system, the researchers noted.

"Providing high quality healthcare to this growing population while attempting to control costs will be a significant challenge," they wrote. "Prevalence results from this study can serve as a benchmark for progress as we move the science of cancer screening in older, diverse adults forward."

Bellizzi KM et al. Arch Intern Med. 2011;171(22):2031-2037. doi:10.1001/archinternmed.2011.570.


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