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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Drs Walter and Covinsky¹ provided an approach for counseling elderly patients about the risks and benefits of cancer screening tests. They claim that their approach is generalizable to other screening interventions beyond primary prevention of cancers.

Although it is generally thought that screening interventions should be judged by their effect on mortality, patients may have other reasons for seeking such tests. For example, imagine a patient who will die in 5 years, with or without screening for breast cancer. But, if in one scenario she will die in her sleep and if in the other die of painful metastatic breast cancer, she may well see an advantage to having the breast cancer diagnosed and treated, even if there is no survival benefit. Realistic estimates of the harms of the disease itself also need to be discussed with patients when providing information for the screening decision.

Walter and . . . [Full Text of this Article]

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RELATED ARTICLE

Cancer Screening in Elderly Patients: A Framework for Individualized Decision Making
Louise C. Walter and Kenneth E. Covinsky
JAMA. 2001;285(21):2750-2756.
ABSTRACT | FULL TEXT