While a majority of older adults agree that guidelines limiting colorectal cancer screenings after 75 are acceptable, a strong minority disagreed, according to a recent cross-sectional study conducted by the University of Michigan in Ann Arbor and reported by MedPage Today Dec. 3.
Here are eight things to know about the findings:
1. The survey compiled responses from more than 1,200 older adults. Approximately 60.4% said that guidelines on stopping CRC screenings at age 75 were acceptable, while 39.6% said the guidelines were somewhat or very unacceptable.
2. The study used data from the Health and Retirement study, an ongoing biennial longitudinal cohort study of about 20,000 U.S. adults aged 50 and older.
3. A subgroup analysis of 304 respondents with limited estimated life expectancy, defined as a score of 8 or more on the Lee Index for 10-year mortality, and 969 respondents with longer life expectancy, defined as a score of 7 or lower, found responses were nearly identical. Of the limited group, 39.2% said the guidelines were unacceptable, as did 39.7% of the less limited group.
4. "These data suggest that limited life expectancy (and the health issues associated with that metric) does not increase older adults' acceptance of guidelines that seek to de-implement low-value care, although less healthy individuals are most likely to benefit and/or avoid unnecessary harms by following such guidelines," the researchers wrote in a letter published in JAMA Open Network.
5. The study "added to the literature about the older adult perspective on CRC screening by disputing the notion that patients with shorter life expectancy will be more likely to choose to stop CRC screening and suggesting that many patients will need strategic, personalized guidance when they face a decision about what age to stop CRC screening," according Leigh Simmons, MD, of Massachusetts General Hospital in Boston, in a commentary accompanying the study.
6. The researchers noted that there could be a number of reasons why a number of patients disagreed with the guidelines, including that many older adults may be undergoing surveillance colonoscopy for a history of colorectal polyps.
7.They also said clinicians should communicate concerns about continued testing for older adults with "sensitivity and clarity."
8. The authors also noted the study's limitations, including a reliance on self-reporting and limited sample size.