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Elderly and Terminally Ill Patients Receiving Costly and Ineffective Cancer Screening Tests

by Nicole Nutter

money wasted on elderly cancer screening?>

<p>Cancer screening has become a significant part of the average American's healthcare regimen. Yearly pap smears and mammograms are suggested to women, prostate exams to men, and both genders are encouraged by the cancer industry to get regular colonoscopies, blood tests and even full-body CT scans. Due to recent research, some healthcare professionals are now questioning not only how necessary these exams are, but also how effective they prove to be. While this practice has undoubtedly led to some cases of early detection and even stopped deaths, studies now show that these tests may do more harm than good.</p>
<p>This is especially true for those with a limited life expectancy, such as elderly women with severe cognitive impairment and terminally ill cancer patients. Researchers from the University of California at San Francisco (UCSF) conducted a study published in the American Journal of Public Health revealing that elderly women with Alzheimer's and other forms of dementia, who are unlikely to live even three more years, are being urged towards unnecessary and expensive mammograms. Of 2,131 seriously cognitively impaired women, nearly 20 percent received mammograms.  Interestingly, the rate of unnecessary screening mammography for these elderly women increased dramatically if they were married and the couple had assets worth tens of thousands of dollars, and it rose to 50 percent if the married couple?s net worth equaled $100,000 or more. 
<p>Would the cancer industry really promote a seemingly ineffective and potentially dangerous procedure to increase the amount of medical bills and profits for healthcare providers? New evidence suggests they just might.</p>

<p>Another study published in a 2010 issue of the Journal of the American Medical Association concluded that many terminally ill cancer patients are undergoing expensive, painful, and common cancer screening tests. According to background information in the study, the usefulness of receiving these screenings for individuals with terminal illness is not sufficiently addressed by current cancer industry screening guidelines. Unfortunately, for those dying of cancer, these tests provide little to no benefits.</p>

<p>The authors stated that, <b>

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.

elderly women at natural health visit

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?

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