Most older adults: Cancer screening guidelines are trash

Older Americans disagree with cancer screening guidelines: ©Truefflepix - stock.adobe.com

A poll conducted by the University of Michigan revealed that a majority of older adults are against the idea of incorporating life expectancy into guidelines that determine who should receive cancer screenings like mammograms and colonoscopies. The findings highlight a divergence in public opinion compared to the trend in national guidelines, which have begun to consider life expectancy in their recommendations.

The poll, which surveyed individuals aged 50 to 80, found that 62% of respondents believed that national guidelines for discontinuing cancer-detecting tests for individual patients should not be based on the person's remaining life expectancy. This perspective challenges the recent shift in guidelines, which use medical evidence to help health care providers determine when to recommend various screening tests. The guidelines also influence insurance coverage decisions.

Guidelines have started to incorporate life expectancy because certain screening tests carry increased risks with age, and studies suggest that individuals need to live approximately 10 more years to fully benefit from early cancer detection.

Even older adults, who tend to minimize medical interventions unless necessary, referred to as "medical minimizers," a majority (57%) opposed using life expectancy in cancer screening guidelines. In contrast, 70% of all older adults surveyed did not view it as problematic if some individuals continued to receive cancer screenings that were not recommended by guidelines.

The poll also inquired about the 10-year life expectancy limit, which has been included in some guidelines. While 55% of respondents considered it appropriate, 27% believed it was too brief.

The study authors emphasized the importance of personalizing cancer screening decisions based on each patient's health situation rather than using universal age cutoffs.

The poll findings also revealed variations in opinions based on gender and ethnicity. Strong disagreement with the use of life expectancy in screening guidelines was more prevalent among women (30%) than men (21%). Black respondents (37%) disagreed more strongly with this practice compared to white (24%) and Hispanic respondents (28%).

Furthermore, 74% of white respondents did not see a problem with older adults receiving cancer screenings against applicable guidelines, compared to 61% of Black and 61% of Hispanic respondents.

While the "medical minimizers" group exhibited lower opposition (57%) to incorporating life expectancy in cancer screening guidelines compared to "medical maximizers," their perspective did not significantly differ from those who fell in between (62%).