While it’s important for aging adults to get regular medical check-up to stay healthy, active and independent, there is a growing concern among geriatricians that too much screening of elderly patients is not only invasive and more likely to do harm than good, it is massively costly.
According to a recent article by Kaiser Health News, excessive medical testing for cancers on the most elderly of patients is unlikely to be of benefit and very likely to cause emotional and physical harm. For example, according to the American Journal of Public Health, nearly 1 in 5 women with advanced dementia are still getting regular mammograms even though they are not recommended for those with a limited life expectancy.
It’s not just elderly women who are still undergoing screenings with little or no benefit; more than half of older men with a high risk of death in the following 10 years are being tested for prostate cancer. A recent JAMA Internal Medicine study found that slow-growing tumors detected by PSA tests are unlikely to cause problems in the patient’s lifetime and they are more likely to die from heart disease, dementia or pneumonia before their cancer poses a risk.
Older patients with dementia rarely live beyond a few years and yet the benefits of cancer screenings are not apparent until an average of 10 years. In many documented cases, terminal cancer patients are still being screened for other cancers or for malignancies in organs that have been removed.
If you are the caregiver for an elderly loved one, especially a senior with dementia, it’s important to carefully consider screenings for cancers that are highly unlikely to provide any patient benefits. Testing can cause anxiety and follow-up procedures may be invasive and cause harm. Intestinal tears from colonoscopies are more likely among patients over the age of 75 and the preparation for the procedure can leave elderly adults dehydrated, lightheaded and more prone to having a fall resulting in injury. Even simple out-patient procedures such as removing slow-growing skin cancers can cause complications. Elderly adults may have difficulty keeping wounds and dressings clean and are less likely to heal well.
While it may be an uncomfortable conversation, doctors and loved-ones need to fully examine the benefit compared with the risks when scheduling medical screenings, especially in elderly patients with dementia. If the goal is to have the best quality of life and to do no harm, it may be time to re-think that next mammogram or PSA test.
To learn more about the cost of unnecessary health services, follow this link to the journal Health Affairs: Datawatch.