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Invited Commentary
Less Is More
August 2017

Talking to Patients About Cancer Screening Cessation

Author Affiliations
  • 1Indiana University Center for Aging Research, Regenstrief Institute Inc, Indianapolis
  • 2Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, Indiana University Health, Indianapolis
  • 3Charles Warren Fairbanks Center for Medical Ethics, Indiana University Health, Indianapolis
JAMA Intern Med. 2017;177(8):1128-1129. doi:10.1001/jamainternmed.2017.1795

There has been a growing realization that many individuals who have advanced illness or multiple medical conditions continue to receive cancer screening that is unlikely to benefit them. Such screening tests may also cause burden owing to the cascade of interventions that follows a positive test result and the burdens of the tests themselves. This has led to an important movement to stop unnecessary cancer screening by considering risks and benefits for individual patients and communicating effectively with the patient when the benefits no longer outweigh the risks.1,2 Screening guidelines are also beginning to consider when cancer screening should be individualized based on factors such as age, comorbidity, or life expectancy. Other guidelines note that evidence is insufficient to recommend a screening test for those older than a certain age.