More than one-half of new cancers and over 70% of cancer deaths in industrialized nations occur in adults age 65 or older. Systematic screening has been associated with reductions in cancer-related mortality for a variety of cancers, including breast, cervical, and colorectal cancer. While increasing numbers of older adults are living beyond 70, few guidelines address cancer screening in this group of older adults. In this article, evidence-based guidelines are reviewed for cancer screening in adults and limitations of screening studies with respect to older adults are discussed. A framework for deciding when to stop cancer screening in older adults is presented based on estimating remaining life expectancy, which incorporates age, comorbidity, and functional status.
Key words: cancer screening, aged, mass screening, overdiagnosis, cancer mortality.