Approaches to and effectiveness of current cancer interventions in the elderly

The effectiveness of early detection depends to a great extent on the particular category of the malignancy. Cancers fall into three categories: 1) Those for which there is evidence that early detection reduces mortality; 2) those for which available evidence indicates that early detection produces no demonstrable mortality reduction; 3) those for which there is insufficient evidence as to the effect of early detection. The use of early detection modalities for these patients is problematic, since such testing can result in unnecessary medical costs and personal burdens. This paper makes some suggestions for practical office screening approaches for cancers of the breast, colon and rectum, cervix, prostate, lung, skin, oral cavity, and endometrium. The evidence relating to screening tests for cancer are reviewed in order to provide a practical approach for the practitioner.