Ourriskofcancerrisesdramaticallyasweage.Soitmakessensethattheelderlyshouldberoutinelyscreenedfornewtumors—ordoesn’tit?
Whilesuchvigilant(警觉的)trackingofcancerisagoodthingingeneralresearchersareincreasinglyquestioningwhetherallofthistestingisnecessaryfortheelderly.Withthepercentageofpeopleoverage65expectedtonearlydoubleby2050it’simportanttoweighthehealthbenefitsofscreeningagainsttherisksandcostsofroutinetesting.
Inmanycasesscreeningcanleadtoadditionalbiopsiesandsurgeriestoremovecancerwhichcancausesideeffectswhilethecancersthemselvesmaybeslow-growingandmaynotposeserioushealthproblemsinpatients’remainingyears.Butthemessagethateveryonemustscreenforcancerhasbecomesoingrainedthatwhenhealthcareexpertsrecommendedthatwomenunder50andover74stopscreeningforbreastcanceritcausedariotousreactionamongdoctorspatientsandadvocacygroups.
It’shardtouprootdeeplyheldbeliefsaboutcancerscreeningwithscientificdata.Certainlytherearepeopleoverage75whohavehadcancersdetectedbyroutinescreeningandgainedseveralextrayearsoflifebecauseoftreatment.Andclearlypeopleoverage75whohaveotherriskfactorsforcancersuchasafamilyhistoryorpriorpersonalexperiencewiththediseaseshouldcontinuetogetscreenedregularly.Butfortheremaindertheriskofcancerwhileincreasedattheendoflifemustbebalancedwithotherfactorslikeremaininglifeexpectancy(预期寿命).
Arecentstudysuggeststhatdoctorsstarttomakemoreobjectivedecisionsaboutwhowilltrulybenefitfromscreening-especiallyconsideringtheexplosionoftheelderlythatwillsoonswellourpopulation.
It’snotaneasycalculationtomakebutonethatmakesenseforthewholepatient.Dr.OtisBrawleysaid“Manydoctorsareorderingthesetestspurelytocoverthemselves.Weneedtothinkabouttherationaluseofhealthcareandstoptalkingabouttherationingofhealthcare.”
Thatmeansmakingsomedifficultdecisionswithelderlypatientsandgoingagainstthemisguidedbeliefthatwhenitcomestohealthcaremoreisalwaysbetter.
【小题1】Whydodoctorsrecommendroutinecancerscreeningforelderlypeople?