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

Abstract

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. The benefits of cancer screening in older adults remain unclear due to minimal inclusion of adults > 75years old in most randomized controlled trials. Indirect evidence suggests that the benefits of screening seen in younger adults (< 70years old) can be extrapolated to older adults when they have an estimated life expectancy of at least 10years. 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.