The research team of Camelia S. Sima, M.D., M.S., of Memorial Sloan-Kettering Cancer Center in New York wanted to discover just how many patients with advanced cancer continue obtaining cancer screening tests. They studied data on 87,736 fee-for-service Medicare enrollees. All were at least 65 years of age, and had been diagnosed with advanced breast, colorectal, gastroesophageal, pancreatic or lung cancer between the years 1998 and 2005. A follow up had been done on the research subjects until December 2007 or until their death, whichever primarily occurred. Researchers found that even after the diagnosis of advanced cancer, nearly 6 percent of women received Pap tests, and almost 9 percent were still given at least one screening mammogram. As for the men with advanced cancer, 15 percent were ordered prostate-specific antigen tests. The number of all patients subjected to colonoscopies after being diagnosed with terminal cancer was almost 2 percent. The question is: why would doctors order these unnecessary and expensive tests? Even when the benefits have been rendered futile in the face of competing risk from advanced cancer, regular cancer screenings still occur because the patients and doctors are simply accustomed to the process and continue the tests, explained the researchers.
Dr. Kala Mehta, a geriatrics researcher and author, said in a statement to the press that, a woman must have a life expectancy of at least four to five years, in order for a mammogram to be useful, otherwise the potential harms are likely to outweigh the benefits, she stated. On average, the elderly women in the UCSF study had a life expectancy of just 3.3 years. In the study of terminally ill cancer patients, they report that a change of policy in Medicare payments for the screenings would make sense, and would likely decrease the amount of unneeded tests. Researchers noted that, the Medicare program might not provide coverage for cancer screening procedures for patients with a life expectancy of less than 2 years.
With more research statistics concluding that the tests prove ineffective, even for the average healthcare patient, one has to wonder who the screenings are actually benefiting. Certainly not the cognitively impaired elderly woman nor the terminally ill cancer patient, neither of whom were given more than three years to live. If the majority of all patients are receiving these often irrelevant tests, maybe the healthcare providers and cancer industry have a different motive, and it may be one beyond putting a stop to cancer and the best health interest of patients.
So, is this screening necessary and/or beneficial? There may not be a simple answer to that question, though statistics seem to support that it is not. Each individual should research and then make an informed decision for themselves. In regards to the terminally ill, is it even ethical?