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Is 75 Too Old For Routine Screening Tests?

Senior patient in doctor's exam room - routine medical testing

If you're 75 or older, you don't need routine screening for breast, colorectal and prostate cancer.

If you're a woman age 65 or older, you don't need to be tested for cervical cancer (the Pap test or Pap smear).

These are the current guidelines from the U.S. Preventive Service Task Force, but a new study finds that many older Americans are being routinely screened for these diseases -- something experts say is unnecessary,  costly for our health care system, and can involve some risk.

The study of almost 50,000 men and women, published this month in the Annals of Internal Medicine, found that Pap smears were performed on more than half of women ages 75 to 79, and 38 percent of women 80 and older.

Nearly 60 percent of men and women ages 75 to 79 had colonoscopies to detect colon cancer, and 42 percent of men age 80 and older had been screened for prostate cancer.

While screening tests have been shown to save lives in younger people, there's less evidence for the benefits of screening tests in the elderly, researchers said.

"At a minimum, in order to see any benefit of screening, you would want your patient to have a life expectancy of more than five years," lead researcher Keith Bellizzi, with the University of Connecticut, told Reuters Health.

Many older adults today are living longer, healthier, active lives than earlier generations, so screening for them might be warranted. But for those in poor health because of multiple medical conditions, some screening procedures could carry some risk and produce very little, if any, benefits.

There's no "one size fits all solution," Bellizzi told USA Today. He said the decision should be based on each person's life expectancy, health status, and personal preferences.

Doctors should also think twice about  screening for cancer in older patients who wouldn't be able to tolerate treatment if cancer was found, he added.

Of course, there's another reason that so many screening exams are being done: "Many docs are ordering these tests purely to cover themselves," from a lawsuit, Otis Brawley, chief medical officer at the American Cancer Society told the newspaper.

"The overwhelming majority of folks over 75 should not be getting these screening tests," he said. "This is an example of waste. We need to think about the rational use of health care and stop talking about the rationing of health care."

Photo credit: Steve Cole/Getty Images

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