CHICAGO — If you knew you had one year to live, would you have medical tests you didn’t need? It turns out a surprising number of patients with late-stage cancer get useless screening tests for new cancers that couldn’t possibly kill them.
A new study of Medicare patients with cancers so advanced they had limited life expectancies and little hope of cure reveals “a culture of screening on autopilot,” said lead author Dr. Camelia Sima of Memorial Sloan-Kettering Cancer Center in New York.
The study found advanced cancer patients got far fewer tests than healthy people. Still, 9 percent of the women received screening mammograms and 6 percent got Pap tests for cervical cancer, 15 percent of the men were checked for prostate cancer and 2 percent of the patients had tests for colon cancer.
“Doing screening tests on patients whose life expectancy is extremely limited because of cancer is just not a cost-effective thing to do,” said Dr. Allen Lichter, chief executive of the American Society of Clinical Oncology, who wasn’t involved in the research.
What’s the harm? Too many tests can raise anxiety in patients and lead to unneeded follow-up tests and treatments that can have serious complications.
But doctors don’t want to steal hope from late-stage cancer patients, Lichter said. Doctors need to have “frank and open discussions of end-of-life planning,” he said.
The study in today’s Journal of the American Medical Association was funded by the National Cancer Institute.
