Cancer screening guidelines are starting to take life expectancy into account, but a new poll shows a majority of older adults do not agree with rounding down ages based on life expectancy.
The University of Michigan’s National Poll on Healthy Aging surveyed more than 2,500 adults ages 50 to 80 in January 2023 by phone and online.
The poll found that 62% of people in this age group think national guidelines for stopping cancer screening for individual patients should not be based on that person’s life expectancy. .
“Personalizing cancer screening decisions to each patient’s health status, rather than using a one-size-fits-all age cutoff, can benefit both very healthy and not-so-healthy patients in a variety of ways. ,” said study author Brian Zikmund Fischer. -Researcher and professor at the University of Michigan School of Public Health in Ann Arbor.
“But when it comes to conversations between health care providers and individual patients, personalizing cancer screening decisions essentially means having a conversation about how long that person will live,” he said at Michigan. Medicine added in a news release. In some cases, you may decide that not screening is actually the healthiest approach. ”
The pollster said guidelines are starting to take life expectancy into account because the risks from some screening tests increase with age. Research also shows that it takes about 10 years of life expectancy to catch cancer early and get the full benefit.
But even among adults who poll staff consider to be “medical minimizers” who avoid medical intervention unless necessary, 57% oppose the idea of using life expectancy as a guideline for cancer screening. Was.
About 70% of adults surveyed believe it is safe for older people to undergo tests that are not recommended.
About 55% of those surveyed said the 10-year life expectancy limit was about right, but 27% said it was too short.
Guidelines help doctors decide which screenings to perform, but they also affect insurance coverage.
The poll’s authors noted that coverage is currently in flux due to federal court litigation that could lead to the termination of insurance coverage needed for cancer screenings and other preventive care under national guidelines. .
“Currently, insurance plans must cover the cost of cancer screening for people in groups covered by guidelines set by the U.S. Preventive Services Task Force. [USPSTF]” explained poll director Dr. Jeffrey Kullgren. He is an associate professor of internal medicine at the University of Michigan and a physician and researcher at the VA Ann Arbor Healthcare System.
“Depending on the final court ruling, insurance coverage for some cancer screenings for some elderly people may be discontinued.Insurance companies may set their own coverage standards. , and they don’t have to follow guidelines,” Kullgren added.
Guidelines for cancer screening also change in response to new evidence about who can most benefit. Draft USPSTF guidelines that could go into effect soon lower the starting age for mammography screening to 40 years old, but still do not support screening women over 75 years old.
Digging further into people’s feelings about using life expectancy in screening recommendations, 26% strongly disagreed with this, including more women than men.
Strong opposition to discontinuing testing based on life expectancy was higher among black respondents (37%) compared to Hispanic participants (28%) and white participants (24%).
According to the results of a public opinion poll, 57% of those who “minimize medical care” opposed the use of life expectancy in cancer screening guidelines, while those who “maximize medical care” opposed the use of life expectancy in cancer screening guidelines. was found to be 73%.