Low Life Expectancy Tied to Cancer Screening

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Second study shows no benefit from CRC screening more intensively than recommended.
Second study shows no benefit from CRC screening more intensively than recommended.

Cancer screening is common among those with limited life expectancy, and more frequent colorectal cancer screening than recommended does not provide benefit, according to two studies published online in JAMA Internal Medicine.

Trevor J. Royce, M.D., from the University of North Carolina at Chapel Hill, and colleagues examined patterns of prostate, breast, cervical, and colorectal cancer screening among 27,404 participants of the National Health Interview Survey, aged 65 years and older, with different life expectancies.

The researchers found that 31 to 55 percent of those with very high mortality risk received recent cancer screening, with the most common screening for prostate cancer. Thirty-four to 56 percent of women who had a hysterectomy for benign reasons had a Papanicolaou test within the past three years. Very high versus low mortality risk correlated with lower odds of screening for prostate, breast, and cervical cancers (odds ratios, 0.65, 0.43, and 0.50, respectively).

RELATED: First Stool DNA Colorectal Cancer Screening Test OK'd by FDA

Frank van Hees, from the Erasmus University Medical Center in Rotterdam, Netherlands, and colleagues examined the benefit of more intensive colonoscopy screening than recommended for Medicare beneficiaries. The researchers found that more intensive screening than recommended correlated with small increases in colorectal cancer deaths prevented and life-years gained.

However, there were large increases in colonoscopies performed and colonoscopy-related complications experienced. There was a loss in quality-adjusted life-years for almost all scenarios of more intensive screening than recommended.

"This study provides evidence and a clear rationale for clinicians and policy makers to actively discourage this practice," van Hees and colleagues write.

  1. Royce, Trevor J., MD, MS, et al. "Cancer Screening Rates in Individuals With Different Life Expectancies." JAMA Internal Medicine. doi:10.1001/jamainternmed.2014.3895. August 18, 2014.

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