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Considerable proportion of patients with advanced cancer continue to undergo common cancer screening
Date:10/12/2010

were individually matched by age, sex, race, and SEER registry to patients with cancer and observed over the same period to evaluate screening rates in context. For both groups, utilization of cancer screening procedures (mammography, Papanicolaou test, PSA, and lower gastrointestinal [GI] endoscopy) was assessed. For each cancer screening test, utilization rates were defined as the percentage of patients who were screened following the diagnosis of an incurable cancer.

The researchers found that among women, following advanced cancer diagnosis compared with controls, at least 1 screening mammogram was received by 8.9 percent vs. 22.0 percent and Papanicolaou test screening was received by 5.8 percent vs. 12.5 percent. Among men with advanced cancer, 15.0 percent received PSA testing compared with 27.2 percent of controls. For all patients following advanced diagnosis compared with controls, lower GI endoscopy was received by 1.7 percent vs. 4.7 percent. Screening was more frequent among patients with a recent history of screening. Higher socioeconomic status and married status were significantly associated with a higher probability of screening for each test evaluated.

"The strongest predictor of screening in the setting of advanced cancer was the receipt of a screening test before diagnosis. The most plausible interpretation of our data is that efforts to foster adherence to screening have led to deeply ingrained habits. Patients and their health care practitioners accustomed to obtaining screening tests at regular intervals continue to do so even when the benefits have been rendered futile in the face of competing risk from advanced cancer," the authors write.

"Our results have several policy implications. First, greater awareness that screening in the face of limited life expectancy from advanced cancer is of dubious benefit may in and of itself limit use. Second, as electronic medical records and reminder systems are developed to fo
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Contact: Courtney DeNicola
denicolc@mskcc.org
212-639-3573
JAMA and Archives Journals
Source:Eurekalert

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