Rates of Screening for Breast, Colorectal, and Cervical Cancers in Older People With Cognitive Impairment or Dementia: A Meta-Analysis

Autor: Marcus Law MD, MBA, MEd, Sandeep Dhillon MD, PhD, Nathan Herrmann MD, Farah Friesen MI, Ayan K. Dey HBSc, Abby Li MSc, A. Patricia Ayala MISt, Erica Lenton MLIS, Jodi D. Edwards PhD, Walter Swardfager PhD
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Gerontology and Geriatric Medicine, Vol 4 (2018)
Druh dokumentu: article
ISSN: 2333-7214
23337214
DOI: 10.1177/2333721418799446
Popis: Purpose: Cancer screening may not be appropriate for some older people. We compare the likelihood of screening for colorectal, breast, and cervical cancers in older people with versus without cognitive impairment or dementia. Method: Systematic search of MEDLINE, Embase, and PsycINFO (to March 9, 2018) for articles reporting screening for colon, breast, and cervical cancers in patients with and without cognitive impairment or dementia. Studies were summarized quantitatively (random effects meta-analysis), according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Studies reported data 1989-2008. The rate of screening for breast cancer by mammography was lower in women with cognitive impairment or dementia compared with those without (pooled odds ratio [OR] = 0.81, 95% confidence interval [CI] = [0.71, 0.91], p = .0007, six studies, N = 18,562). The rates of screening for cervical cancer by Pap smear (pooled OR = 0.88, 95% CI = [0.71, 1.08], p = 0.22, five studies, N = 409,131) and colorectal cancer by fecal occult blood test (pooled OR = 0.87, 95% CI = [0.55, 1.38], p = .55, two studies, N = 2,718) were not significantly lower in people with cognitive impairment or dementia. Conclusion: These historical rates provide a baseline for discussions around the need for more specific guidance to assist with decisions to discontinue screening. The study also identifies a gap in reported knowledge with respect to screening under current guidelines.
Databáze: Directory of Open Access Journals
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