Cancer Screening in Elderly Healthy Survivors

Cancer screening is indicated when you are expected to live long enough to benefit. What's going on when physicians order screening tests for elderly patients whose life expectancy is too short? The conclusion of a recent NYTimes article is clear: Too Many Older Patients Get Cancer Screening. The varied explanations include...

  • Patients request screening...
    • because they overestimate benefits and underestimate risks
    • out of habit or a sense of duty
  • It's easier to continue screening than discuss life expectancy
    • Physicians can avoid the conversation
    • Patients don't want to hear about their life expectancy
  • Physicians fear lawsuits, if patients then develop cancer
  • Physicians fear perception of ageism or not caring

    Healthy Survivors obtain sound knowledge, including knowledge of the risks of benefits of every test and treatment for them.  Throughout life, updated facts will tell if the benefits outweigh the risks of specific tests and treatments. As their condition changes over time, including changes due to normal aging, the equation will change. What stays the same is making wise decisions in keeping with their values.

    How can physicians get around the discomfort of discussing the truth that the patient is not expected to live long enough to benefit. A JAMA (Journal of the American Medical Association) article offers a healing alternative, "These tests won't help you live longer or better."

    Healthy Survivors benefit from physician-patient relationships built on trust and open communication. This way, they can use sound knowledge to make healing decisions every step of the way.

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