Cancer screening can save lives: Mammographies reduce the chance women will die of breast cancer; and colonoscopies reduce the chance people will die of colon cancer.
But should my 93-year-old father receive a screening colonoscopy? The test is uncomfortable, carries risks, and costs money. Even more importantly, my dad probably won’t live long enough to benefit from the test. That’s why most medical experts think people like my dad—people unlikely to live another decade—should not receive cancer screening tests like colonoscopies. But how in the heck is my dad’s doctor supposed to deliver this news to him?
My father’s primary care doctor could tell him: “I have good news for you. You don’t need a colonoscopy—you’ll probably die of something else before colon cancer gets you!” But according to recent research, that message isn’t likely to go over well with its audience. The study, out of Johns Hopkins, convened senior citizens and asked them what they thought about conducting screening tests in patients of advanced age. The people told researchers that they understood the concept of stopping testing when people get too old to benefit. But they did not like the thought of doctors telling them that their impending mortality is the reason they will no longer receive such testing. “You’re too old to benefit” is a harsh message.
So what should physicians do?
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