Health screening tests are designed to identify serious medical conditions early. The earlier a condition is identified, the better the chances that the treatment will be successful. Studies show that screening tests such as mammograms, colonoscopies, and prostate-specific antigen (PSA) tests have saved or extended countless lives over the past decades.
Experts have produced guidelines about when routine screening should begin, and physicians usually follow those guidelines. But what we do not hear much about is at what age these screening tests can be ceased. The same experts who recommend starting ages for tests also give ages when many of these tests can be stopped or done less frequently. Their recommendations are based on studies that show that, after a certain age, specific treatments will be of little benefit or have risks that are greater than the risks of the condition.
Many physicians, however, continue to recommend testing to their patients even when the data show little usefulness. A recent study of 30,000 men over age 70 underscores this dilemma. The U.S. Preventive Services Task Force has long recommended that men ages 70 and above not have PSA tests done. They base their recommendations on data that show that men above age 70 will likely die of something other than prostate cancer. Thus, testing is of little benefit, and over-testing can lead to unnecessary treatments, many of which can have serious side effects. Yet the study found that over 50 percent of those men were being tested—including almost 40 percent of men over age 80. The study’s authors found that elderly patients asking for these tests was a common issue, and few were advised of the guidelines. There are similar guidelines concerning mammograms and colonoscopies based on age and history of cancer.
Here are some tips to help you decide if you should continue to get routine screening.
Do your research. No matter what the screening test you are considering, do your research. Do online searches about the test. Check what expert guidelines recommend for a person your age and your medical history. Also, check out the treatments that are likely if the testing finds something wrong. Are you willing to undergo those treatments? What are the potential side effects?
Speak with your doctor. It’s important that you have a serious discussion with your doctor about the value of a specific screening test. Ask your doctor if there is anything that can be done if something is found. If so, what are the potential side effects or longer-term effects of the treatment. In other words, is the treatment worse or riskier than the condition?
What’s best for you. Guidelines are simply that—guides for you and your doctor to take into consideration when deciding on the benefit of a particular screening test. The important consideration is what is most appropriate for you, regardless of your age, and taking into consideration your overall medical status.