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How old is too old for cancer screening? (Feb-11)

Cancer screening is generally recommended for people over the age of 50. Screening tests, such as colonoscopies, mammograms and PSAs (prostatespecific antigen), can help detect cancer at an early stage andprevent deaths. These screening tests, however, do have risks so,along with their doctor, people need to make a decision about howoften to get screened and when or if one should stop gettingscreened.

Consider the question:

Now, imagine that you were screened for cancer about a year ago and no cancer was found. You and your doctor are talking about when you should come back for screening in the future. Your doctor explains that cancer screening guidelines recommend that you do come back for more screening tests but as you get older, screening for cancer is no longer a good option. Your doctor states that you should follow this recommendation as you age. Now, imagine that you were screened for cancer about a year ago and no cancer was found. You and your doctor are talking about when you should come back for screening in the future. Your doctor explains that cancer screening guidelines recommend that you do come back for more screening tests but as you get older, screening for cancer is no longer a good option. Your doctor states that you should follow this recommendation as you age.

Would you plan to stop getting screening tests for cancer at a certain age?
  • Yes
  • No

How do your answers compare?

In a recent study published in the Journal of General Internal Medicine, CBSSM Investigators and Mick Couper and Brian J. Zikmund-Fisher, together with lead author Carmen Lewis (Department of Medicine, University of North Carolina) and several co-authors, explored decisions about stopping cancer screening tests. This study was part of the DECISIONS study, a large survey of U.S. adults about common medical decisions.
Recently, the US Preventive Services Task Force recommended against prostate screening for men aged 75 and older, and recommended against routine screening for CRC screening after age 75 and any CRC screening after age 85. Cancer screening for prostate cancer, CRC and breast cancer helps to detect cancer at an early stage when they are easier to treat. However, as a person gets older, the risks of these tests become larger than the benefits.
Data was collected from 1,237 individuals aged 50 and older who reported having made one or more cancer screening decisions in the past 2 years. Participants were asked about their plans of whether or not to stop cancer screening as well as characteristics of themselves and their health care provider.
Only 9.8% of people planned to stop getting screened for cancer when they reached a certain age. This percentage varied by type of cancer, age and race of the participant and how much the participant was responsible for the decision apart from their health care professional.
Of the 119 people who gave a specific age that they planned to stop getting cancer screening the average age they did or plan to stop was 74.8 for breast cancer, 76.8 for colon cancer and 82.9 for prostate cancer.
The study authors concluded that “plans to stop screening were uncommon among participants who had recently faced a screening decision”. They also concluded that further research is needed to understand how people think about the risks and benefits of screening when life expectancy is short and that education around this topic may be beneficial.

To learn more about this study, see:


CBSSM Seminar: Rana Awdish, MD

Thu, February 15, 2018, 3:00pm
NCRC, Building 16, Room 266C

Dr. Rana Awdish is the author of In Shock, a memoir based on her own critical illness. She is also Director of the Pulmonary Hypertension Program at Henry Ford Hospital in Detroit and a practicing Critical Care Physician. She lectures to physicians, health care leaders and medical schools across the country on the necessity of compassionate care. She was recently named Medical Director of Care Experience for the Health System.

In Shock will describe Dr. Awdish's personal transformation from critical care physician to critically ill patient and describe how the events surrounding her near death changed her understanding of the culture of medicine and lead her to alter the course of her institution. Focusing on Physician communication training, narrative medicine and visual thinking strategies, and a culture of caring, she will illuminate the path towards creating a more resilient culture for everyone involved in health care.


1. Describe the ecosystem of medical training and practice and the way it compromises empathy and compassion.

2. Illustrate how medical humanities and a purpose driven culture can be used to promote a culture of resilience.

3. Recognize the barriers to implementing institutional change and empowering individuals.

4. Identify practices that will engage providers and leaders in promoting development of resilient systems.

Rana Awdish, MD
Director, Pulmonary Hypertension Program, Henry Ford Hospital, and Medical Director, Care Experience, Henry Ford Health System, Detroit, MI

Dr. Rana Awdish is the Director of the Pulmonary Hypertension Program at Henry Ford Hospital in Detroit and a Critical Care Physician. She also serves as Medical Director of Care Experience for the Henry Ford Health System. Dr. Awdish’s mandate as well as her passion is to improve the patient experience across the system. 

After suffering a sudden critical illness herself in 2008, she has become a tireless activist, refocusing her fellow providers on the patient experience and improving empathy through connection and communication. She lectures to physicians, hospital leadership and medical schools around the country. Her book, In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope, has been featured in the Washington Post, NPR, The Today Show, The Times Literary Supplement, and is now an LA Times Bestseller.

Dr. Awdish received the Schwartz Center’s National Compassionate Caregiver of the Year Award in 2017. She was named Physician of the Year by Press Ganey in 2017 for her work on improving communication, and received the Critical Care Teaching Award in 2016. She, along with three others, began the CLEAR Conversations Project at Henry Ford, using improvisational actors to train physicians in patient-centered empathic communication. 

Prior to coming to Henry Ford, Dr. Awdish completed her training at Mount Sinai Beth Israel in Manhattan. She attended Wayne State University Medical School, and completed her undergraduate degree at the University of Michigan in Ann Arbor. She is board-certified in Internal Medicine, Pulmonary and Critical Care Medicine.

Mon, January 06, 2014

Dr. Reshma Jagsi worked on a study detailing the decline of US research spending versus the increase in spending in Japan and China. In the UMHS article, she says, "The United States has long been a world leader in driving research and development in the biomedical science. It's important to maintain that leadership role because biomedical research has a number of long term downstream economic benefits, especially around job creation," 

Research Topics: 

CBSSM Seminar: Jan Van den Bulck, PhD

Tue, November 28, 2017, 3:00pm
NCRC, Building 16, Room 266C

Jan Van den Bulck, PhD
Professor, Communication Studies

"Are the media (re-)defining how we interact with each other and with the world?

We know everything there is to know about people we have never even met. Through social media, we follow their every move. We even know their pets. Our media use interferes with healthy sleep, family meals, or even our work. Our children need levels of self-control to manage distractions that threaten their schoolwork. Or do they?"

Tue, November 28, 2017

In a study published in JAMA Internal Medicine, Jeff Kullgren and co-authors found that few individuals enrolled in High-Deductible Health Plans (HDHPs) in the United States are engaging in consumer behaviors.

The 2012 CBSSM Research Colloquium took place on Thursday, May 10, and was attended by over 130 people.  This year's colloquium focused on research around medical decision making, and featured presentations by numerous faculty, fellows, and students.  In addition, the CBSSM Research Colloquium featured the annual Bishop Lecture in Bioethics as its keynote address.  Drs. Jerome Groopman and Pamela Hartzband of Harvard Medical School jointly presented the Bishop Lecture with a talk entitled, "When Experts Disagree: The Art of Medical Decision Making."  For more information about the event and to view photos and a video of the Bishop Lecture, click here.

Dr. Jason Karlawish, Professor of Medicine and Medical Ethics at the University of Pennsylvania, will discuss his forthcoming novel, "Open Wound: The Tragic Obsession of Dr. William Beaumont" on Thursday, October 20, 3-5 pm, at the Biomedical Research Science Building (BSRB), Room 1130.  "Open Wound" is a fictional account of true events along the early 19th century American frontier, tracing the relationship between Dr. William Beaumont and his illiterate French Canadian patient.  The young trapper sustains an injury that never heals, leaving a hole in his stomach that the curious doctor uses as a window both to understand the mysteries of digestion and to advance his career.  A reception will follow the talk, and books will be available for purchase on site from Nicola's Books.  The event is co-sponsored by the Center for Bioethics and Social Sciences in Medicine, the Center for the History of Medicine, and the University of Michigan Press.  Click here for more information about the book. 

Tue, September 20, 2011

The CBS News website recently featured 10 tips to make better decisions about cancer care from U-M’s Angela Fagerlin, Ph.D., associate professor of internal medicine. Below is an excerpt from the article:

Cancer is scary, and doctors sometimes sound as if they’re speaking a foreign language when talking about the disease and its treatment. But “people are making life and death decisions that may affect their survival and they need to know what they’re getting themselves into,” says Fagerlin “Cancer treatments and tests can be serious. Patients need to know what kind of side effects they might experience as a result of the treatment they undergo.”


Fri, October 27, 2017

An older Behavioral Economics study by Brian Zikmund-Fisher and Andrew Parker was recently highlighted in a Nerdwallet Blog about the continued demand for rent-to-own contracts.

Research Topics: