Treatments

Terminally Ill Get Cancer Screenings, Despite Lack Of Benefit

All those reflexive Pap smears, mammograms, and prostate cancer screening tests are controversial enough these days.

Mammograms

hide captionDoes a woman diagnosed with breast cancer need more mammograms?

Damian Dovarganes/AP

But, one thing's pretty clear: They don't really help patients already dying of other cancers.

That's the conclusion of a report just out from the specialists at Memorial Sloan-Kettering Cancer Center in New York.

In the study, they looked at more than 87,000 Medicare patients over 65 diagnosed with advanced lung, colorectal, and breast cancers, and compared them to an equal number of healthy patients to see how many got screenings.

What they found was that 9 percent of women diagnosed with terminal cancer were given mammograms after diagnosis  — compared to 22 percent who were healthy.

Also, 15 percent of men with terminal cancer were still screened for prostate cancer, compared to 27 percent who were cancer-free. This despite the American Cancer Society's new guidelines that say PSA testing need not be routine.

The reasons for continued screening varied, according to the article published in JAMA. The strongest predictor of who got screened post-cancer diagnosis was if they had a history of screening tests before diagnosis.

It's a matter of habit. "Patients and their healthcare practitioners accustomed to obtaining screening tests at regular intervals continue to do so even when they benefits have been rendered futile in the face of competing risk from advanced cancer," the report says.

"Furthermore, we hypothesize that neither primary care physicians nor oncologists routinely engage in the difficult discussions that require explanation of why continuation of procedures to which patients have become accustomed to is no longer necessary," the report continues.

Translation — doctors aren't really talking to us about our options.

Screening in this already terminally ill population could lead to overdiagnosis, the researchers say, meaning they find cancers that would otherwise go undetected and are less serious than the one already detected.

Not a focus of the study but worth a mention:The potential cost burden of unnecessary testing — all these patients in the study get government-funded health care.

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