Many older adults skeptical about stopping colon cancer screening at 75
A research letter published in JAMA Network Open reveals a surprising divide among older Americans about when to stop colon cancer screening. While medical guidelines suggest halting routine screenings at age 75, nearly 40% of adults find this recommendation unacceptable—regardless of their personal health status.
Researchers from the University of Michigan surveyed over 1,200 adults and discovered that while 60% accepted guidelines recommending an end to colon cancer screening after 75, a significant minority disagreed. What's particularly intriguing is that this skepticism remained consistent across different groups, including those with shorter and longer estimated life expectancies.
“Our findings suggest that limited life expectancy does not necessarily change how older adults view these screening guidelines, even though less healthy individuals are most likely to benefit from stopping unnecessary screenings,” said Laura Brotzman, first author of the study and a doctoral student in the Department of Health Behavior & Health Equity at the University of Michigan School of Public Health.
The study examined data from the University of Michigan Health and Retirement Study, based at the Institute for Social Research.
Findings expand views and attitudes on cancer screening
Brotzman and several co-authors of the JAMA Network Open letter have previously looked at older adults’ views on how cancer screening guidelines should be made. Data released in September 2023 from the National Poll on Healthy Aging showed that 62% of adults aged 50-80 disagreed with using life expectancy to determine when to stop cancer screening. Notably, women were more likely to oppose such guidelines, with 66% expressing reservations compared to 57% of men.
University of Michigan researchers Brian Zikmund-Fisher, professor of Health Behavior & Health Equity, and Jeffrey Kullgren, associate professor of Internal Medicine and director of the National Poll on Healthy Aging, were involved in both projects and noted that the research highlights a critical challenge in healthcare: balancing medical recommendations with patient preferences.
“While guidelines aim to protect older adults from unnecessary risks—such as complications from screening procedures—many patients remain hesitant to stop testing,” Zikmund-Fisher said. “The truth is, every one of us needs to consider the fact that, at some point in our lives, it will probably make sense to stop getting these tests.”
The data explored in both pieces of research underscore the need for more nuanced conversations between doctors and patients about the benefits and limitations of cancer screening in later life.
Kullgren and Zikmund-Fisher are members of the University of Michigan Institute for Healthcare Policy and Innovation.
Research Letter: “Acceptability of Guidelines to Stop Colon Cancer Screening by Estimated Life Expectancy.” JAMA Network Open. doi:10.1001/jamanetworkopen.2024.47802
National Poll on Healthy Aging: Older adults’ views on cancer screening guidelines
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