Screening for cancer

2017 ◽  
pp. 707-712
Author(s):  
Anne Horgan ◽  
Shabbir M. H. Alibhai
Keyword(s):  
Prostate Cancer ◽  
Older Adults ◽  
Life Expectancy ◽  
Early Identification ◽  
Remaining Life ◽  
Supportive Evidence ◽  
Curative Intent ◽  
Remaining Life Expectancy ◽  
Breast And Prostate Cancer ◽  
Potential Methods

Cancer screening is the early identification of an asymptomatic malignancy. The aim of screening is to identify cancer at a stage where it can be more effectively treated and ideally with curative intent. Guidelines regarding screening in the older population differ widely across countries, in part due to the underrepresentation of older adults in the large screening trials on which the recommendations are based. In this chapter, we present the screening recommendations for colorectal, lung, breast, and prostate cancer from four international groups. The benefits of screening in the overall population are highlighted, and the data supporting screening in older adults outlined. Factors to be considered in screening decisions are discussed, including remaining life expectancy and patient and physician wishes. Potential methods to overcome these challenges along with supportive evidence are highlighted.

PSA screening rates in older men in the United States based on nine-year estimated remaining life expectancy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16006-e16006
Author(s):  
Michael Drazer ◽  
Sandip M. Prasad ◽  
Dezheng Huo ◽  
Mara A Schonberg ◽  
Russell Zelig Szmulewitz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Life Expectancy ◽  
National Health Interview Survey ◽  
Older Men ◽  
The United States ◽  
Informed Decision Making ◽  
Remaining Life ◽  
Psa Screening ◽  
Interview Survey ◽  
Remaining Life Expectancy

e16006 Background: PSA screening for prostate cancer (PCa) is controversial, but informed decision making is recommended for men with an estimated 10 years of remaining life expectancy (RLE). The association between screening of men 65+ and estimated 9-year life expectancy is unknown. Our purpose was to determine the association between predicted 9-year life expectancy and PCa screening in 2005 and 2010. Methods: Data were extracted from the 2005 and 2010 National Health Interview Survey. Men 65+ without prostate known PCa were divided into quartiles with a validated index estimating 9-year RLE (<27%, 27-52%, 53-75%, and >75%). The proportions of men screened in 2005 and 2010 were determined. Logistic regression was used to compare screening in 2005 and 2010. Results: Screening rates for men 65+ were 48.3% (95% CI, 45.6-50.9%) in 2005 and 48.5% (95% CI, 45.5-51.6%) in 2010 (p = 0.9). There were no differences in screening between cohorts by age and predicted mortality for 65-74 (all p > 0.05 for <27%, 27-52%, 53-75%, and >76% predicted mortality) and 75+ year olds (all p> 0.05). The most screened group were 65-74 year olds with a <27% chance of 9-year mortality, with 58.3% (95% CI, 53.6–63.1) and 56.1% (95% CI, 50.6-61.5) screened in 2005 and 2010. Conclusions: PSA-based PCa screening did not differ between 2005 and 2010 for men 65+. Over 35% and 33% of older men with limited estimated 9-year RLE were screened in 2005 and 2010 despite minimal clinical benefit. [Table: see text]

scholarly journals Geographic variation in gender gap among older adults in India and China: Application of a new ageing measure

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 870-871
Author(s):  
Arun Balachandran ◽  
Feinian Chen
Keyword(s):  
Older Adults ◽  
Life Expectancy ◽  
Old Age ◽  
Gender Gap ◽  
Functional Health ◽  
Remaining Life ◽  
Multiple Dimensions ◽  
Remaining Life Expectancy ◽  
Almost All ◽  
India And China

Abstract A continuous rise in the life expectancy of females above that of the males among older adults in India and China may give an impression that the gender gap in health is decreasing. However, given the systemic bias against females in these countries across multiple facets, and the diversity across provinces, a fuller understanding of gender gap calls for (a) understanding the gender gap in multiple dimensions of health, and (b) understanding the variations across provinces. We estimate a multi-dimensional old-age threshold (MOAT) across provinces in India and China, that specifies different old-age thresholds for female and male populations after simultaneously accommodating for multiple dimensions related to their health. These aspects of health include remaining life expectancy, intellectual and functional health. We estimate the gender gap across provinces in these countries by differencing the MOAT of males against that of females. In addition, we also illustrate the gender gap across individual dimensions of health. Our results show that females in almost all the provinces of India and China have a lower MOAT than their male counterparts, showing an earlier advent of ‘old-age’ among females compared to males. The estimates based on remaining life expectancy shows gender gap in favor of females, but the estimates of multi-dimensional gender gap are higher and biased against females. A huge variation is seen across provinces, with Karnataka and Hubei showing lower levels of gender gap and Rajasthan and Yunnan showing higher gender gaps in India in China respectively.

scholarly journals Growing Income-Based Inequalities in Old-Age Life Expectancy in Sweden, 2006–2015

Demography ◽  
2021 ◽  
Author(s):  
Stefan Fors ◽  
Jonas W. Wastesson ◽  
Lucas Morin
Keyword(s):  
Income Inequality ◽  
Life Expectancy ◽  
Life Span ◽  
Old Age ◽  
Remaining Life ◽  
Neighborhood Deprivation ◽  
Income Gap ◽  
Remaining Life Expectancy ◽  
Mortality Improvement ◽  
Income Quartile

Abstract Sweden is known for high life expectancy and economic egalitarianism, yet in recent decades it has lost ground in both respects. This study tracked income inequality in old-age life expectancy and life span variation in Sweden between 2006 and 2015, and examined whether patterns varied across levels of neighborhood deprivation. Income inequality in remaining life expectancy at ages 65, 75, and 85 increased. The gap in life expectancy at age 65 grew by more than a year between the lowest and the highest income quartiles, for both men (from 3.4 years in 2006 to 4.5 years in 2015) and women (from 2.3 to 3.4 years). This widening income gap in old-age life expectancy was driven by different rates of mortality improvement: individuals with higher incomes increased their life expectancy at a faster rate than did those with lower incomes. Women with the lowest incomes experienced no improvement in old-age life expectancy. Furthermore, life span variation increased in the lowest income quartile, while it decreased slightly among those in the highest quartile. Income was found to be a stronger determinant of old-age life expectancy than neighborhood deprivation.

scholarly journals Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

2020 ◽  
Author(s):  
Wen-Ling Liao ◽  
Yu-Hung Chang
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Life Expectancy ◽  
Early Onset ◽  
Late Onset ◽  
Remaining Life ◽  
Iadl Disability ◽  
Disability Free Life Expectancy ◽  
Onset Group ◽  
Early Onset Group

Abstract Objectives: This study aims to identify the age trajectories of disability in instrumental activities of daily life (IADLs) over 11 years and their correlates, and to estimate disability-free life expectancy for identified trajectory groups in middle-aged and older adults.Methods: We included 3,118 participants aged 50 and over without IADL limitations at baseline from the Taiwan Longitudinal Study in Aging, followed across 1996-2007. We used group-based trajectory models to identify age trajectories of IADL disability, and multiple logistic regressions to examine their correlates. Sullivan method was used to compute IADL disability-free life expectancy for trajectory groups at different ages.Results: We identified two trajectories groups: 67.7% of participants classified as the late-onset group and 32.3% as the early-onset group. Female (adjusted odds ratio [aOR]: 1.93, 95% confidence interval [95% CI]: 1.54, 2.41), not being employed (aOR: 1.30, 95% CI: 1,08, 1,56), poor/fair self-rated health (aOR: 1.31, 95% CI:1.09, 1.58), hypertension (aOR: 1.32, 95% CI: 1.07, 1.63) , diabetes mellitus (aOR: 2.29, 95% CI: 1.72, 3.07), arthritis (aOR: 1.42, 95% CI: 1.11, 1.81), stroke (aOR: 2.21, 95% CI: 1.04, 4.70), and one-point increase in a 10-item depression scale (aOR: 1.04, 95% CI: 1.02, 1.06) were associated with early-onset of disability, whereas higher education (aOR: 0.59, 95% CI: 0.42, 0.81), regular exercise (aOR: 0.76, 95% CI: 0.62, 0.93), and participating voluntary or club activities (aOR: 0.78, 95% CI: 0.65, 0.93) related to the late-onset. IADL disability-free life expectancies at 65 years old in the late-onset group were 15.6 years for women and 14.4 for men, respectively, comprising 56.6% and 64.2% of their remaining life, whereas those of the early-onset group were 4.8 and 4.6 years for women and men respectively, comprising 22.5% and 27.2% of remaining life.Conclusions: Early-onset of IADLs disability may correlate to chronic conditions, and engagement in employment, exercise, and social participation were associated with a reduced risk of early disability in IADLs.

Mortality prediction and demographic ageing

Stanovnistvo ◽  
2000 ◽  
Vol 38 (1-4) ◽  
pp. 7-28
Author(s):  
Jean-Paul Sardon
Keyword(s):  
Life Expectancy ◽  
Elderly People ◽  
Human Life ◽  
Scientific Progress ◽  
Mortality Rates ◽  
Mortality Prediction ◽  
Human Longevity ◽  
Remaining Life ◽  
Demographic Ageing ◽  
Remaining Life Expectancy

Since 1970 age at death has much increased. This is greatly due to quick diminishing of old age mortality rates and sheds a new light on the analysis of the probable and possible variations to be expected regarding mortality. Projected numbers of elderly people depend a great deal on the choices made regarding future mortality. When comparing forecasted hypothetical mortality with recent actual achievements it is obvious that a certain amount of pessimism prevails in the forecasts. This prompts us to show greater boldness when forecasting. However, will the present rise in life expectancy, especially at higher ages, continue at the same pace or will it tend to reach its zenith (the biological limit of human life) and when? According to some experts, we are already approaching the limits of average human longevity, whereas for others, scientific progress will amply enable us to push back the age of 85 years determined by the former group. Improvement in the understanding of the multifactorial process of ageing will feed the debate but the economic, social and behavioural constraints of lengthning life spans should not be overlooked. Nevertheless and whatever age limit is set to define elderly people, based on a fixed or a varying age, as the age at which remaining life expectancy is constant, a sharp increase in numbers of elderly people is to be expected.

Individual fecundity dynamically predicts remaining life expectancy in medflies

2006 ◽  
Author(s):  
Vassili N. Novoseltsev ◽  
James R. Carey ◽  
Janna A. Novoseltseva ◽  
Anatoli I. Yashin
Keyword(s):  
Life Expectancy ◽  
Remaining Life ◽  
Remaining Life Expectancy ◽  
Individual Fecundity
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