Cancer Screening Among Older Adults: a Geriatrician's Perspective on Breast, Cervical, Colon, Prostate, and Lung Cancer Screening

被引:18
作者
Kotwal, Ashwin A. [1 ,2 ]
Walter, Louise C. [1 ,2 ]
机构
[1] Univ Calif San Francisco, Dept Med, Div Geriatr, San Francisco, CA 94143 USA
[2] San Francisco VA Med Ctr, Geriatr Palliat & Extended Care Serv Line, 4150 Clement St 181G, San Francisco, CA 94121 USA
关键词
Older adults; Cancer screening; Mammogram; PSA test; Colon cancer; Lung cancer; COLORECTAL-CANCER; TUMOR CHARACTERISTICS; LIFE EXPECTANCY; DECISION AID; AGED; 65; MORTALITY; MAMMOGRAPHY; WOMEN; OVERDIAGNOSIS; COMPLICATIONS;
D O I
10.1007/s11912-020-00968-x
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose of ReviewWe summarize the evidence of benefits, harms, and tools to assist in individualized decisions among older adults in screening for breast, prostate, colon, lung, and cervical cancer.Recent FindingsThe benefits of cancer screening in older adults remain unclear due to minimal inclusion of adults >75 years old in most randomized controlled trials. Indirect evidence suggests that the benefits of screening seen in younger adults (<70 years old) can be extrapolated to older adults when they have an estimated life expectancy of at least 10 years. However, older adults, especially those with limited life expectancy, may be at increased risk for experiencing harms of screening, including overdiagnosis of clinically unimportant diseases, complications from diagnostic procedures, and distress after false positive test results.SummaryWe provide a framework to integrate key factors such as health status, risks and benefits of specific tests, and patient preferences to guide clinicians in cancer screening decisions in older adults.
引用
收藏
页数:12
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