Assessment of Clinician Decision-making on Cancer Screening Cessation in Older Adults With Limited Life Expectancy

Current clinical practice guidelines recommend against routine cancer screening in older adults with less than 10 years of life expectancy. Yet, these older adults often still receive screening, with rates as high as 55% in national US studies. Thus, this study  posed the question, “how do clinicians and patients think about stopping cancer screening in older adults with limited life expectancy?”. They conducted semi-structured interviews with 25 primary care clinicians and 47 patients. The findings show that cancer screening decisions were not always conscious or deliberate. When the decisions were deliberate, they were associated with not only patient characteristics, but also subjective factors such as patient request, clinicians’ anecdotal experiences, and the patients’ family and friends. This study adds to the existing literature on clinician decision-making about cancer screening in older adults. These findings suggest that strategies to facilitate more deliberate decision-making may be important in cancer screening of older adults with limited life expectancy.  

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