Cancer screening after the age of 75: Nationwide population-based trends

Abstract

Objectives

Cancer screening among older adults above 75 years of age is frequent despite generally not being recommended in evidence-based guidelines. We aimed to describe trends in prostate, cervical, breast, and colorectal cancer screening after the age of 75.

Setting

This descriptive cross-sectional study analysed the 2007, 2012, 2017, and 2022 waves of the nationwide population-based Swiss Health Survey. Residents of Switzerland were invited through state-stratified multistage probability sampling.

Methods

For each wave, we calculated weighted overall and sex- and age-stratified proportions of any, prostate, cervical, breast, and colorectal cancer screening in the past 12 months explicitly for preventive non-symptomatic purposes among older adults above 75 years of age.

Results

Analytical sample sizes ranged from 1450 (2007) to 2276 (2022). Across waves, populations aged and had increasing education levels. Over time, any cancer screening in the past 12 months was undertaken by one in four older adults aged above 75 (25.4% in 2007; 24.3% in 2022), where proportions were persistently higher among men (31.8% in 2007; 28.3% in 2022) than women (21.3% in 2007; 20.8% in 2022). In all waves, screening decreased with increasing age (2022: 29.7% among people aged 76–80, 14.8% among people aged 86 years and above). Prostate cancer screening decreased from 26.0% (2007) to 21.0% (2022), with no substantial changes for other screening types.

Conclusions

Cancer screening after the age of 75 has been frequent and stable across time despite not being recommended, emphasising the need for further evidence on screening effectiveness and harms among older adults.