From the Guidelines
Annual health screenings can be discontinued at age 85 for colorectal cancer screening, as recommended by the USPSTF 1, and at age 75 or older for breast cancer screening in average-risk women, as suggested by the American College of Physicians 1. The decision to stop annual screenings should be based on a person's age, overall health, life expectancy, and the specific screening test in question. Some key points to consider when deciding to discontinue screenings include:
- Life expectancy: most preventive screenings can be discontinued when a person's life expectancy is less than 5-10 years or when the potential harms of screening outweigh the benefits.
- Health status: for colorectal cancer screening, most guidelines suggest stopping at age 75-85, depending on health status.
- Screening test: mammography for breast cancer screening typically continues until age 74-75 for women with average risk, while cervical cancer screening can stop at age 65 for women with adequate prior negative screening.
- Individual values and preferences: the decision to stop screening should ultimately be personalized through shared decision-making between patients and healthcare providers, taking into account individual values, preferences, and health status, as emphasized by the American College of Physicians 1. For example, a study published in the Annals of Internal Medicine found that the average time to prevent 1 death from colorectal cancer for 1000 patients screened was 10.3 years 1, highlighting the importance of considering the time from screening to potential mortality benefit when making decisions about discontinuing screenings. Additionally, the American College of Physicians recommends discontinuing screening for breast cancer in average-risk women aged 75 years or older or in women with a life expectancy of 10 years or less 1. Overall, the decision to discontinue annual health screenings should be based on a careful consideration of the potential benefits and harms of screening, as well as individual patient factors, and should be made in consultation with a healthcare provider.
From the Research
Discontinuing Annual Health Screenings
There are no specific studies that directly answer the question of at what age annual health screenings can be discontinued. However, several studies provide guidance on screening recommendations for different types of cancer:
- Colorectal Cancer Screening: Most guidelines recommend screening between 45 and 75 years for average-risk individuals 2.
- Breast Cancer Screening: The US Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 40 to 74 years, but concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older 3.
- Cancer Screening in Older Adults: A study found that clinicians often consider screening cessation for older adults with limited life expectancy, but the decision-making process varies across different types of cancer screenings 4.
Key Findings
- The age range for discontinuing annual health screenings is not explicitly stated in the provided studies.
- Screening recommendations vary depending on the type of cancer, individual risk factors, and age.
- The USPSTF recommends biennial screening mammography for women aged 40 to 74 years, but the evidence is insufficient to determine the balance of benefits and harms for women 75 years or older 3.
- A systematic review found that the balance of benefits and harms of different screening intervals for breast cancer screening is still a matter of debate 5.
Screening Recommendations
- Average-risk individuals should undergo colorectal cancer screening between 45 and 75 years 2.
- Women aged 40 to 74 years should undergo biennial screening mammography 3.
- The decision to discontinue annual health screenings should be made on a case-by-case basis, considering individual risk factors, age, and overall health status 4, 6, 5, 3.