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Age is important in cancer screening

The age band is rarely explicitly considered in screening programmes and somewhat arbitrarily selected, yet it is critical to their success and cost effectiveness, suggests research in the Journal of Medical Screening.

The research included a new, simple solution on which to ...
The age band is rarely explicitly considered in screening programmes and somewhat arbitrarily selected, yet it is critical to their success and cost effectiveness, suggests research in the Journal of Medical Screening.

The research included a new, simple solution on which to base future screening policy.

The research team evaluated the number of cumulative years of life lost to different cancers at different ages. They used national statistics on cause of death, to determine the ages at which the greatest loss occurred, and to identify priorities for screening. The results indicated that screening would be most effective at saving lives if done around five years before this critical peak was reached.

The peak for breast cancer, for example, is currently 55-59 (189 years of life lost per 10,000 women-a-year). This compares with 50-54 for cervical cancer (47 years of life lost).

The research also showed that extending breast cancer screening to the age of 74 would be more effective than cervical screening at any age. It also showed that the current cervical screening policy should be extended to age 69, because more lives are lost to cervical cancer among those in their 70s than in women under 30, who are currently targeted for screening.

The authors concluded that screening for breast and cervical cancers offers the greatest benefits, and that prostate screening would be worthwhile if trials showed that it reduced death.

"An important advantage of the life years lost approach is that it allows for life expectancy being lower in old age. Its apparent simplicity conceals its importance. Consideration of age should form the foundation of public health screening policy," said the authors.
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