Stopping screening in older adults.

• A. Continue screening indefinitely.
• B. Stop at age 65 regardless.
• C. Stop when harms outweigh benefits due to age, comorbidity, and limited life expectancy; consider patient preferences.
• D. Stop only when patient asks to stop.

Answer: (C)

The main idea is that decisions about stopping screening in older adults should be based on whether the likely benefits of screening would outweigh the potential harms within the person’s remaining life expectancy. As people age or accumulate health problems, the chance that screening will actually prevent a meaningful outcome (like cancer mortality) diminishes, while the risks of screening and its follow-up tests—false positives, unnecessary procedures, complications, anxiety—become more prominent. Because of this, there is no universal age to stop; instead, clinicians should tailor the decision to the individual’s health status and time horizon.

In practice, if a patient has limited life expectancy or significant comorbidity such that the benefits of screening would not be realized within their remaining years, stopping is appropriate. Importantly, patient preferences matter; some may choose to continue screening for peace of mind, while others may prioritize avoiding potential harms. The key is to weigh harms and benefits within the person’s specific context and revisit the decision as health status changes.