When To Stop Screening For Colorectal Cancer? New Study Says No Need To Screen Older People With Three Or More Chronic Diseases

Main Category: Colorectal Cancer
Also Included In: Seniors / Aging
Article Date: 09 Nov 2006 - 18:00 PDT

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A study of people 67 years and older who were diagnosed with colon cancer found that those with three or more chronic diseases at the time of diagnosis had life expectancies of five years or less (Article, p. 646). Life expectancy was strongly related to both age and the burden of chronic illness.

Authors say that since randomized trials have shown that a mortality difference between screened and unscreened patients does not become clear until five years after screening, physicians should consider the patient's age and number and nature of chronic diseases when deciding whether to screen and when to stop screening.

The authors acknowledge that colorectal cancer screening is underutilized, with perhaps only 50 percent of eligible patients receiving appropriate screening, but they point out that the screening has both risks and costs, so it is important to identify the patients who are most likely to benefit from screening.

An editorial writer cautions that screening decisions -- and treatment decisions -- should not be based on life expectancy numbers alone (Editorial, p. 700). "Physicians must talk to their patients about their preferences for treatment and their knowledge of the options."

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Tip sheet Annals of Internal Medicine, Nov. 7, 2006

NOTE: Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information.

Contact: Susan Anderson
American College of Physicians

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