Cancer Screening in the Older Adult

Cancer incidence increases with age. It is the second most common cause of death in older adults. Prevention and early detection of certain cancers helps preserve quality of life and offers the possibility of a cure with less aggressive treatments. Lifestyle modifications and healthy behaviors can mitigate the modifiable cancer risks. Screening tests must be effective, safe, and well tolerated with acceptably low rates of false positive and false negative results. Some people diagnosed with preclinical cancer will die from competing causes. Older patients require an individualized approach in decision-making. Estimation of life expectancy, comorbid disease burden, and status on the fit-frail spectrum are important steps. The risk benefits of cancer screening should be discussed with the older adult and family/caregivers to arrive at a decision whether to screen or not. In this chapter, we describe the current prevention and screening recommendations for some common cancers where they exist.