Older patients with shorter life expectancies may receive less benefit from colorectal cancer screening


We demonstrated that colorectal cancer screening may have limited utility for patients with a substantial burden of chronic illness.  For patients who received a diagnosis of cancer, a stage I cancer diagnosis would represent the best-case scenario for enjoying the benefits of early detection. That is, cancer screening provides the greatest benefit to those patients who have a cancer that is identified while it is still at a small, curable stage.  It is important to note that in many instances, small cancers may take up to five years before they grow large enough to cause symptoms and affect health.  However, we found that men and women with 3 or more chronic conditions had a life expectancy of approximately 5 to 6 years if they were in their early 70s at diagnosis.  Given that screening takes up to five years to yield a mortality benefit, the utility of screening such patients is questionable.

 

Bibliographic reference:

Gross CP et al.: "The effect of age and chronic illness on life expectancy after a diagnosis of colorectal cancer: implications for screening", Ann Intern Med. 2006 Nov 7;145(9):646-53

 

Cary P Gross

Robert Wood Johnson Clinical Scholars Program and Primary Care Center, Yale University School of Medicine, New Haven, Connecticut, USA