Kerri Fitzgerald

DocwireNews

A study of more than 60,000 individuals indicated that those who do not adhere to cancer screening guidelines are at an increased risk of all-cause mortality unrelated to cancer malignancies. This finding came from a secondary analysis of the Prostate, Lung, Colorectal and Ovarian Cancer Screening (PLCO) trial and was published in JAMA Internal Medicine.Researchers randomized patients from 10 U.S. screening centers between November 8, 1993, and July 2, 2001. Patients were originally followed for 13 years or through December 31, 2009, but participants re-consented to further follow-up starting May 18, 2011, and were observed through December 31, 2012. A total of 64,567 patients (29,537 women and 35,030 men; mean age = 62.3 years) were included in the analysis.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
This is why as treated analysis is problematic: 64k participant RCT of cancer screening shows those who were nonadherent to ca screening had increased non-cancer mortality. File this away to rebut those who want to do per protocol/as treated analyses.<a href="https://t.co/60scT1QrtM">https://t.co/60scT1QrtM</a> <a href="https://t.co/alhVXgV6OY">pic.twitter.com/alhVXgV6OY</a>
&mdash; Venk Murthy MD PhD (@venkmurthy) <a href="https://twitter.com/venkmurthy/status/1078744032619229184?ref_src=twsrc%5Etfw">December 28, 2018</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>At baseline, participants completed a self-administered questionnaire. Individuals were classified as those receiving all sex-specified PLCO cancer screening tests at baseline (adherent; n=55,065; 85.3%), those receiving some baseline tests (partially adherent; n=2,548; 3.9%), and those receiving no baseline tests (nonadherent; n=6,954; 10.8%).At 15 years of follow-up, there were 7,966 deaths, excluding those from the cancer, among patients who were adherent, 449 deaths among those who were partially adherent, and 1,395 deaths among those who were nonadherent.Within 10 years of follow-up, the hazard ratio (HR) of mortality, excluding deaths from cancers and controlling only for age, sex, and race/ethnicity (model 1), was 1.73 (95% CI, 1.60-1.89) for nonadherent individuals compared with adherent participants. The HR of mortality was 1.36 (95% CI, 1.19-1.54) for partially adherent individuals compared with fully adherent participants.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
Why Is Nonadherence to <a href="https://twitter.com/hashtag/Cancer?src=hash&amp;ref_src=twsrc%5Etfw">#Cancer</a> <a href="https://twitter.com/hashtag/Screening?src=hash&amp;ref_src=twsrc%5Etfw">#Screening</a> Associated With Increased Mortality? <a href="https://t.co/2HEoMYanEf">https://t.co/2HEoMYanEf</a>
&mdash; Ray DuBois, MD, PhD (@Rndubois) <a href="https://twitter.com/Rndubois/status/1080476773903667200?ref_src=twsrc%5Etfw">January 2, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>After adjusting for medical risk factors for mortality and behavioral-related factors such as obesity and smoking (model 2), the HR decreased to 1.46 (95% CI, 1.34-1.59) for nonadherent patients compared with adherent participants. Those who did not undergo screenings were 46% more likely to die compared with 26% of those who skipped some screenings.&ldquo;It was not a direct effect of missing the cancer screening that led to the increased mortality in the noncompliers,&rdquo; Paul Pinsky, PhD, of the National Cancer Institute, told Reuters. &ldquo;Rather, we believe that noncompliance with the screening was a marker of a wider health behavioral profile of general noncompliance with or nonadherence to medical tests and treatments. Non-compliance with medical procedures has also been linked, in this and other studies, to other unhealthy lifestyle factors such as obesity and smoking, and to lower education.&rdquo;<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
In a large cancer screening trial, nonadherence to cancer screening tests was associated with increased mortality among middle-aged and older adults (excluding screened for cancers) <a href="https://t.co/0mHdULQHmU">https://t.co/0mHdULQHmU</a>
&mdash; Joseph Ross (@jsross119) <a href="https://twitter.com/jsross119/status/1078990234006839296?ref_src=twsrc%5Etfw">December 29, 2018</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script><a href="https://proddocwire.wpengine.com/docwire-pick/colorectal-cancer-screening-45/">An analysis of pros and cons of colorectal cancer screening at age 45.</a><a href="https://proddocwire.wpengine.com/abstracts/stratified-screening-breast-cancer/">Cost-effectiveness and benefit-to-harm ratio of risk-stratified screening for breast cancer.</a>Source: <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2719426">JAMA Internal Medicine</a>

Jordana Jampel

Positive Preliminary Results From Phase 1 Trial of Dopaminergic Neuron Graft for Parkinson’s Disease

Dementia

Bradley Warady, MD

Joel M. Topf, MD, FACP

2025 Hume Award Winner Is Dedicated to Children’s Care

NKF Spring Clinical Meetings 2025

Distant Brain Metastases in Cutaneous Melanoma May Be Mitigated With Multiple Pathway Inhibitors

Melanoma

Latest News

Nonadherence to Cancer Screening Associated With Mortality Unrelated to Cancer

Oncology

A study of more than 60,000 individuals indicated that those who do not adhere to cancer screening guidelines are at an increased risk of all-cause mortality unrelated to ...

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe