Patients diagnosed with cancer who only have a few remaining years of life left still often undergo routine mammograms, PSA tests and colonoscopies tests that are needless and wasteful because they re highly unlikely to benefit the patients screened, researchers of a new study in the Journal of the American Medical Association say. To compare the use of cancer screening tests, the team matched Medicare patients aged 65 and older with advanced lung, colorectal, pancreatic and other cancers, to Medicare cancer-free patients of the same age, sex and race. Of the women diagnosed with an incurable cancer, 9 percent received a mammogram and 5.8 percent underwent a Pap test compared to 22 percent of healthy patients who got a mammogram and 12.5 who received a Pap test. The ratios were similar among men, where 15 percent of those with advanced cancer got a PSA test compared to 27.2 percent of healthy patients.
Dr. Therese Bevers of the University of Texas M.D. Anderson Cancer Center told Reuters that cancer patients who have less than 10 years to live should be spared the wasted time and added worry that screening tests may cause, since they don t stand to benefit from such tests.
Miracles may happen, but if a patient has been diagnosed with cancer metastatic to several organs, then I wouldn t recommend a mammogram or Pap test, says ACSH's Dr. Gilbert Ross. Unfortunately, doctors don t want to look patients in the eye and give them this devastating but wise advice.
The study researchers propose that Medicare could simply decline to pay for cancer screening tests in patients with less than two years to live in order to combat the problem, but Dr. Ross doesn t think this strategy would work. Doctors would first have to assess patient life expectancy and then Medicare would have to come up with some automatic way of denying coverage. Instead, doctors should be responsible for not ordering exams such as colonoscopies for patients who only have a few years to live why would someone want to go through that if they don t have to?
