Patients with cancer that has already spread are being screened for new cancers despite little benefit to the patient, according to new research by ICES and Sunnybrook Health Sciences Centre.
The study published CMAJ Open found that nearly one in 20 patients underwent tests for colorectal cancer and nearly one in 11 women underwent screening for breast cancer, within a year of receiving their diagnosis of metastatic cancer.
Dr. Simron Singh, medical oncologist, and Dr. Matthew Cheung, haematologist, conducted the research. They say cancer screening is extremely important in catching cancers early, and it can save lives. But, when a person is already undergoing treatment for advanced cancer, screening is typically of little or no benefit — and instead can cause distress.
What are the key takeaways from this study?
Screening can save lives. That’s important to remember. The screening programs for breast cancer and colorectal cancers are extremely successful – and we are really pleased that Ontarians are getting the message about getting screened.
For the people we looked at in the study — people already facing advanced stage cancers — screening instead can be stressful, uncomfortable and ultimately of no benefit. For patients with advanced cancer, time is likely better spent focusing on symptom control and quality of life as opposed to pursuing additional tests that are unlikely to offer benefit.
What does this mean for patients?
For healthy Ontarians, continue to take part in cancer screening programs.
For those with advanced cancers, when you receive a reminder about a routine screening, talk to your oncologist to determine whether or not screening tests would be beneficial to you.
What does this mean for care providers?
We hope this research spurs more conversations between oncologists and their patients, and a more personalized approach to screening. Oncologists and family physicians should talk to their patients who have advanced cancers about screening for other cancers.
Why did you want to study this?
Choosing Wisely Canada is a movement that is looking at reducing unnecessary tests, and its recommendations include not doing routine cancer screening on people who already have advanced cancers. We wanted to see how often this was happening, and it turns out, it’s happening far more than we initially thought. During our study period, 1 in 11 women with advanced cancer underwent breast cancer screening and 1 in 20 people with advanced cancer underwent colorectal cancer screening. These tests aren’t without risk of complications and can be extremely difficult for people who are already ill.
What comes next?
Currently, all Ontarians receive reminders in the mail when it’s time to take part in a cancer screening program, like the Ontario Breast Screening Program. We are looking at whether the wording on those reminders could be tweaked to provide some advice for people already facing cancers to speak with their oncologist.
