Cancer screening outside of age recommendations: a population-based study

Cancer screening outside of evidence-based recommendations can be considered a form of low-value care. We aimed to describe the frequency of colorectal, breast, cervical, and prostate cancer screening outside of recommended age guidelines in Switzerland.

We analysed data from the 2022 Swiss Health Survey. Of 21,930 participants aged 15 or more, 20,515 (9,555 men and 10,960 women) were included in this study. We calculated age at last screening and classified individuals as having been not screened, screened within age-specific A, B, and C recommendations from the United States Preventive Services Taskforce (USPSTF), screened within age-specific A and B recommendations, or screened outside of recommendations.

Among adults aged 75 years and above (75+), 40.2% (men: 35.1%; women: 44.5%) had undergone cancer screening outside of USPSTF A, B, and C recommendations. This proportion was 26.0% for adults aged 85+ (men: 27.8%; women: 24.6%). Cervical cancer screening was the most frequently undertaken outside of recommended ages by older adults (women aged 75+: 37.1%), followed by prostate (men aged 75+: 34.0%), breast (women aged 75+: 17.8%), and colorectal cancer screening (adults aged 75+: 1.3%). Screening outside of recommendations was also observed among middle-aged adults 40-59 at 12.3% (men: 20.8%; women 4.0%), and younger-aged women 20-39 at 9.9%. Proportions for screening outside of USPSTF A and B recommendations were high (adults 75+: 50.4%; adults 85+: 40.6%; adults 40-59: 20.9%).

Cancer screening outside of recommendations is highly prevalent, particularly among older adults. Further research is needed to better understand drivers of this form of low-value care.