How should predicted cancer screening decisions for older adults guide life expectancy?


The new Johns Hopkins Medicine study suggests that cancer tests (mammograms for women and prostate exams for men) for older adults should be individualized and not based on expected life expectancy. Credit: public domain image

Doctors say timely and accurate examinations can facilitate early detection and reduce cancer mortality rates. However, for those 65 and older, current guidelines for deciding whether to have cancer screening are sometimes based on the likelihood that the person will live 10 years, the time it normally takes to get benefits. of the procedure. In a recent study, medical researchers Johns Hopkins examined a large group of older Americans to better understand the relationship between cancer screening and the likelihood of a person dying in a decade.

A report on the results of the study was published on June 1, 2021 a JAMA network open.

“Understand the relationship between and death can help inform how we should use a patient’s chances of dying within ten years to produce cancer decisions, ”says the study’s lead author, Nancy Schoenborn, MD, an associate professor of medicine at Johns Hopkins University School of Medicine.

For their study, Schoenborn and colleagues used data from the Health and Retirement Study, an ongoing representative survey of more than 37,000 people over the age of 50 in 23,000 households in the United States. We included 5,342 participants, 3,257 women, and 2,085 men, age 65 and older, who were eligible for breast or prostate cancer screening. The average age of women was 78 years and that of men was 76 years.

The researchers used statistical methods to investigate the association between a person who had breast or prostate cancer screening and whether that person lived or died from any cause for the next 10 years. The researchers took into account the age of each person, , ability to perform daily functions and other factors currently used to predict .

The researchers found that women who received a mammogram and men who underwent prostate screening had a lower risk of death, even after adjusting for age and other health factors.

Researchers say this is probably due to differences between the types of people who complete cancer screening and those who do not, rather than being caused by the screenings themselves. Researchers say this suggests that for people who are recommended for cancer testing, the algorithms used to predict life expectancy may underestimate the results.

“Based on our findings, we believe that cancer testing should be individualized and not just based on projected life expectancy,” says Schoenborn. “The doctor and the patient work together in each individual situation to make the decision whether or not to screen detection.”

Schoenborn says future research by his team in this area of ​​precision medicine is expected to identify what is different in people who receive projections of those who do not and what differences may be associated with better survival.

“We can use this knowledge to improve how life prediction is predicted and, in turn, how these predictions are used in clinical decision-making,” he says.

Americans lost nearly 10 million cancer screenings during the pandemic

More information:
Nancy L. Schoenborn et al, Association between cancer screening reception and all-cause mortality in older adults, JAMA network open (2021). DOI: 10.1001 / jamanetworkopen.2021.12062

Citation: How Should Expected Life Expectancy Guide Cancer Screening Decisions for Older Adults? (2021, June 24), retrieved June 24, 2021 at

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