Older adults are overscreened for cancer

  • Moss JL & al.
  • JAMA Netw Open
  • 1 Jul 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Overscreening for colorectal, cervical, and breast cancer among older adults is high, particularly for women living in metropolitan areas.

Why this matters

  • Screening patients who are older than the recommended US Preventive Services Task Force (USPSTF) cutoff age and/or with limited life expectancy may cause more harm than good.

Study design

  • Overscreening was assessed in cohorts of 20,937 men and 34,244 women for colorectal cancer, 82,811 women for cervical cancer, and 38,356 women for breast cancer.
  • Funding: National Cancer Institute; the American Cancer Society.

Key results

  • Rates of patients being screened outside the USPSTF cutoff age:
    • 59.3% of men and 56.2% of women screened for colorectal cancer.
    • 45.8% of women screened for cervical cancer.
    • 74.1% of women screened for breast cancer. 
  • Participants aged ≥80 vs
  • Overscreening was more common (aORs; 95% CIs) in metropolitan vs nonmetropolitan areas for:
    • Colorectal cancer among women: 1.23 (1.08-1.39).
    • Cervical cancer: 1.20 (1.11-1.29).
    • Breast cancer: 1.36 (1.17-1.57).
  • Overscreening for cervical and breast cancers was associated with having a usual source of care, good/very good/excellent self-reported health, education beyond high school, and being married or living as married.

Limitations

  • Observational; recall bias.