How often are seniors receiving cancer screening?

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 - Comorbidity-adjusted life expectancy optimizes screening recommendations

Many breast and prostate cancer screenings performed on the nation’s elderly are unnecessary and should not be recommended under current guidelines, according to research published online Jan. 21 in  JAMA Oncology.

Overdiagnosis stemming from these exams is estimated to cost the U.S. healthcare system $1.2 billion annually, despite established guidelines recommending against screening for breast and prostate cancer in individuals with limited life expectancy.

How widespread this excessive screening has become merits investigation, according to Firas Abdollah, MD, and his colleagues at the Henry Ford Health System in Detroit. “With the aging population and an expected surge of older individuals with prostate cancer and breast cancer in upcoming years … a contemporary nationwide and state-by-state assessment of the prevalence of nonrecommended screening for prostate cancer and breast cancer is essential and timely,” the authors wrote.

To obtain this assessment, Abdollah and his colleagues analyzed the responses of nearly 150,000 individuals aged 65 and older as part of the 2012 Behavioral Risk Factors Surveillance System survey.

The results showed that more than half of seniors (51 percent) had undergone either mammography or prostate cancer screening within the past year. Of those patients, nearly a third (30 percent) had a life expectancy of 10 years or less.

The overall rate of unnecessary screening across the nation was 15 percent, with rates varying widely from state to state. Additionally, states with high rates of excessive mammography were more likely to have correlating rates of unnecessary prostate screenings.

Their findings could prove useful in revealing specific regions and states to target in the effort to reduce overdiagnosis due to excessive screening, according to the researchers.

"Efforts should be deployed to reduce non-recommended screening in states with a high rate of non-recommended screening," wrote Abdollah et al. "This effort may avoid significant harms to many individuals and improve the cost efficiency of screening initiatives."