Cancer Screening and Surveillance Testing for Older Adult Cancer Survivors

Presenter: Nancy L. Keating

In older adult cancer survivors, cancer screening and surveillance testing carry benefits and harms that depend on a variety of factors. Benefits of screening include early diagnosis and a lower risk of death from cancer. Harms include false-positive results, unnecessary biopsies, incidental findings, and overdiagnosis. The primary factor in deciding whether older adult cancer survivors should undergo screening or surveillance testing is life expectancy, but other factors also come into play, such as a patient’s health status, goals, and values. An individualized approach as well as shared decision-making are crucial when working with patients to make these important decisions.

Disclosures: Dr. Keating has disclosed no relevant financial relationships.

Correspondence: Nancy L. Keating, MD, MPH, Dana-Farber/Brigham and Women’s Cancer Center, Department of Health Care Policy, 180 Longwood Avenue, Boston, MA 02115. Email: keating@hcp.med.harvard.edu
  • 1.

    Shapiro CL. Cancer survivorship. N Engl J Med 2018;379:24382450.

  • 2.

    Marcus PM, Bergstralh EJ, Zweig MH, et al. Extended lung cancer incidence follow-up in the Mayo Lung Project and overdiagnosis. J Natl Cancer Inst 2006;98:748756.

  • 3.

    HealthDecision. Breast cancer screening decision support tools. Accessed February 1, 2022. Available at: healthdecision.org/tool#/

  • 4.

    Lee SJ, Boscardin WJ, Stijacic-Cenzer I, et al. Time lag to benefit after screening for breast and colorectal cancer: meta-analysis of survival data from the United States, Sweden, United Kingdom, and Denmark. BMJ 2013;346:e8441.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Dotan E, Walter LC, Beechinor R, et al. NCCN Clinical Practice Guidelines in Oncology: Older Adult Oncology. Version 1.2022. Accessed January 10, 2022. To view the latest version of these guidelines, visit NCCN.org

    • Search Google Scholar
    • Export Citation
  • 6.

    Schonberg MA, Breslau ES, McCarthy EP. Targeting of mammography screening according to life expectancy in women aged 75 and older. J Am Geriatr Soc 2013;61:388395.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Freedman RA, Keating NL, Pace LE, et al. Use of surveillance mammography among older breast cancer survivors by life expectancy. J Clin Oncol 2017;35:31233130.

  • 8.

    Freedman RA, Minami CA, Winer CA, et al. Individualizing surveillance mammography for older patients after treatment for early-stage breast cancer: multidisciplinary expert panel and International Society of Geriatric Oncology consensus statement. JAMA Oncol 2021;7:609615.

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 406 406 406
PDF Downloads 125 125 125
EPUB Downloads 0 0 0