Personalizing Age of Cancer Screening Cessation Based on Comorbid Conditions: Model Estimates of Harms and Benefits

• DOI: 10.7326/m13-2867
• Publication Date: 2014-07-14T22:35:04Z
• Authors: Iris Lansdorp-Vog...; Roman Gulati; Angela B. Mariotto; Clyde B. Schechter; Tiago M. de Carvalho; Amy B. Knudsen; Nicolien T. van R...; Eveline A.M. Heij...; Chester Pabiniak; Marjolein van Bal...; Carolyn M. Rutter; Karen M. Kuntz; Eric J. Feuer; Ruth Etzioni; Harry J. de Koning; Ann G. Zauber; Jeanne S. Mandelb...
• Keywords: Cancer screening; Overdiagnosis

Background: Harms and benefits of cancer screening depend on age comorbid conditions, but reliable estimates are lacking. Objective: To estimate the harms by conditions to inform decisions about cessation. Design: Collaborative modeling with 7 simulation models common data average condition level–specific life expectancy. Setting: U.S. population. Patients: cohorts aged 66 90 years in 2010 health or 1 4 levels: none, mild, moderate, severe. Intervention: Mammography, prostate-specific antigen testing, fecal immunochemical testing. Measurements: Lifetime deaths prevented life-years gained (benefits); false-positive test results overdiagnosed cases (harms). For each level, at which were similar that for persons having 74 years. Results: Screening 1000 women expectancy breast resulted 79 96 (range across models) results, 0.5 0.8 cases, 0.7 0.9 deaths. Although absolute numbers differed sites, ages cease consistent sites. no, severe until 76, 74, 72, years, respectively, average-health persons. Limitation: Comorbid influenced only Conclusion: an important determinant screening. Estimates can discussions between providers patients personalizing cessation decisions. Primary Funding Source: National Cancer Institute Centers Disease Control Prevention.