Cancer screening across the aging continuum

Abstract

Objectives: To review current screening guidelines and practice related to cancer screening among older adults and to establish a best practice approach to screening for older individuals applicable to all levels of care.

Study design: A comprehensive literature search was performed with consideration given to research and practice.

Methods: Review article.

Results: There is some evidence to support the effectiveness of screening for cancer among older adults, particularly when comorbidity, functional status, and life expectancy are considered. Moreover, most older individuals (at least the subpopulations of well-educated individuals of white race/ethnicity) have positive attitudes about cancer screening and are willing to engage in available screening tests. However, strict adherence to any of the selected guidelines for all older individuals can result in unnecessary stress and burden to some individuals related to screening and subsequent testing. Furthermore, screening for all older adults regardless of age and status has ethical implications for the community at large.

Conclusion: Providers should take an individualized approach to screening that addresses the immediacy of the screening benefit, associated risks of screening, preferences of the patient or his or her proxy, ethical concerns (eg, the futility of screening or treatment), and the patient's life expectancy, health status, and quality of life.