Recently, a new study published on JAMA Oncology found that many older Americans are getting screened for breast and prostate cancer unnecessarily. These extra screenings could lead to treatments that the patients do not require. Researchers estimated that these extraneous screenings could cost over $1.2 billion per year.
The reason this is so is that nearly 16% of those screened are estimated to have less than 10 years left to live. A 10-year life expectancy is generally considered to be a milestone for deciding whether or not to screen. Established guidelines recommend against screening for breast and prostate cancer in people with a life expectancy less than 10 years.
Dr. Firas Abdollah of the Henry Ford Health System in Detroit noted that; “Physicians, as well as patients, should consider life expectancy when deciding the necessity of prostate cancer or breast cancer screening,” These unneeded screening, researchers concluded, lead only to furthered expense of all parties involved with no tangible advantage to the recipient.
The reasons this issue is so endemic amongst senior patients is still not fully understood though it is postulated that busy doctors simply do not have the time or will to individual patients the concept of life expectancy and why screening is not needed or recommended for certain individuals.
Robert Smith, vice president for cancer screening at the American Cancer Society, elucidated on the nature of this problem, saying; “This can be a hard conversation for doctors to have with patients. If a patient shows some enthusiasm for getting these tests, it’s just easier to do the test than it is to have that conversation, especially if you’re not that good at doing it.”
However, the methods by which someone “deduces” whether or not someone has 10 years left to live are dubious. There really is no way to tell. Thus, it is easier for doctors to conduct screenings of these individuals even though there is absolutely no reason to outside of convenience.
Currently, U.S. Preventive Services Task Force screening guidelines call for mammograms for women up to age 74. However, they recommend no screening for prostate cancer at all.
Furthermore, extraneous treatment for falsely diagnosed tumors can be equally damaging. Screening for cancers in patients this old can often lead to false alarms. These “false alarms” low-risk tumors that have little to no chance of becoming volatile. This false alarm can lead to unnecessary treatment that have harmful consequences which can catalyze death or severely hinder one’s quality of life in their final years.
Ultimately, the study found that these extraneous treatments end up being a triple loss to all parties involve as they cost more money, lead to false alarms, and can severely hinder life expectancy and/or reduce the quality of life. Doctors are currently looking into this study and making changes accordingly. Of course, doctors would rather save lives than save money, so of top priority to them is ensuring every malevolent cancer is caught early and treated effectively.
For information, please visit JAMA Oncology