Weighing the Benefits of Cancer Screening for Older Adults
< Dec. 14, 2011 > -- As the American population continues to age, should doctors set an upper age limit for cancer screening?
Nearly 37 million people in the U.S. are 65 or older, and that number is expected to double by 2030. The U.S. Preventive Services Task Force recommends against routine screening for breast, colorectal, and prostate cancer at age 75 and beyond, and advises against cervical cancer testing after 65.
Yet many older adults today are living longer - and healthier - lives and so could benefit from continued screening, says Keith Bellizzi, Ph.D., at the University of Connecticut and lead author of a new study.
"At the same time, there are segments of the older adult population with limited life expectancy, poor health status, and concomitant health conditions that would likely not benefit from screening," Bellizzi says. "The challenge is, how do we make this determination?"
Looking at the numbers
To help define the issue, Bellizzi and his team looked at data on nearly 50,000 people who were part of the National Health Interview Study.
Among women in the study who were 75 to 79 years old, 62 percent had received a screening mammogram in the past two years, and 50 percent of women 80 and older had had one. Pap screens for cervical cancer were done on 53 percent of women 75 to 79 and 38 percent of women 80 and older.
Fifty-seven percent of men and women 75 to 79 were screened for colon cancer in the previous two years. Prostate cancer screening was done for 57 percent of men 75 to 79 and 42 percent of men 80 and older.
People older than 75 were most likely to be screened for cancer if a doctor recommended it, Bellizzi's team found. College-educated men and women were most likely to be screened, and those without a high school diploma were least likely to get screened.
The study was published in the current issue of the Archives of Internal Medicine.
The study results point to the need for doctors to look at more than a patient's age when recommending screening, Bellizzi says. "Screening decisions should be individualized based on life expectancy, health status, an informed discussion with the patient about the potential harms and benefits, and patient values and preferences."
Otis Brawley, M.D., at the American Cancer Society, says, however, that he's not convinced that elderly adults need cancer tests. "The overwhelming majority of folks over 75 should not be getting these screening tests, because we have no science that shows these tests are going to benefit these folks by making them live longer," he says.
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Exercise for Good Senior Health
Finding ways to get exercise as you get older is a smart, easy way to stay fit and improve your health. Regular exercise can help boost heart health, maintain a healthy body weight, keep joints flexible and healthy, and improve balance to minimize falls.
Exercise can take many forms, including activities that feel more like fun than hard work:
Dance. Sign up for a dance class with your spouse or a friend or carve out some dance time at home.
Go bowling. Join a bowling league or make a weekly date with some of your friends. If you have grandchildren, bring them along.
Rediscover a favorite sport. Whether you love the elegance of golf or the challenge of tennis, make time for these leisure activities. If possible, vary your activities over the course of each week to work different muscle groups.
Enjoy the great outdoors. When the weather cooperates, ride your bike, visit a local park for a hike, or simply go for a walk. These are all great exercises that get you outside and into the fresh air.
Get in the swim. Swimming is an excellent exercise choice, particularly if you have arthritis joint pain. Join a local fitness center with a pool and work in regular swims to meet your cardiovascular needs without straining your joints.
Always talk with your health care provider to find out more information.
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Agency for Healthcare Research and Quality - Checklists to Help Men and Women Stay Healthy at 50-Plus
American Cancer Society - Guidelines for the Early Detection of Cancer
Archives of Internal Medicine - Prevalence of Cancer Screening in Older, Racially Diverse Adults