BACKGROUND AND PURPOSE:

• Most guidelines recommend against screening for cancer when life expectancy is <10 years
• Schoenborn et al. (JAMA Internal Medicine, 2022) examined physicians’ attitudes about using life expectancy as a criterion for stopping cancer screening in older adults

METHODS:

• Survey study
• Population
  • Primary care physicians: Internal medicine | Family medicine | General practice | Geriatric medicine | Gynecology
• Study design
  • Primary care physicians were asked about breast, colorectal, or prostate cancer screenings in older adults (≥65 years)
  • Gynecologists were asked about breast cancer screening in older adults
• Primary outcome
  • Whether a <10-year estimated life expectancy was considered a reasonable criterion for stopping screening

RESULTS:

• 791 eligible respondents
• Physicians who agreed that life expectancy <10 years was a reasonable criterion for stopping cancer screening: 75.2%
  • Primary care physicians: 81.3%
  • Gynecologists: 56.5%
• The following were associated with lower odds of using life expectancy as criteria for stopping screening
  • Gynecology specialty: OR 0.41 (95% CI, 0.24 to 0.69)
  • Older physician age: OR 0.77 (95% CI, 0.66 to 0.89) per 10 years
  • Black race: OR 0.41 (95% CI, 0.21 to 0.79)
• Physicians who perceived overscreening as a substantial problem in older adults: 38.8%
• Physicians who believed that the use of life expectancy as a criterion for stopping cancer screening could introduce biases against
  • Racial and ethnic minorities: 45.4%
  • Those of lower socioeconomic status: 48.4%
• Physicians who believed that life expectancy prediction algorithms were accurate for making cancer screening decisions: 35.1%

CONCLUSION:

• Approximately 25% of physicians surveyed did not believe that life expectancy should be used as a criterion for stopping cancer screening
• Additionally, many physicians believed that using life expectancy to determine cancer screening could introduce biases

Learn More – Primary Sources:

Physician Attitudes About Using Life Expectancy to Inform Cancer Screening Cessation in Older Adults—Results From a National Survey

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