Most people want to live a long time, and many people want to be good patients. So they do their screening tests, like mammograms and colonoscopies.
Unfortunately, sometimes these tests are done for too long. At an advanced age, these tests are unlikely to be beneficial.
For example, the American College of Surgeons says that you probably don't need a colonoscopy (or any other colon cancer screening) if your life expectancy is less than 10 years, you're not having symptoms and you haven't had colon or rectal cancer in the past.
The American Geriatrics Society says be careful about screening for cancers - breast, colon, prostate, and lung - if life expectancy is limited.
And the American Society of Breast Surgeons says you should not get a mammogram if you have a life expectancy of less than 5 years, you have no symptoms and you have a normal physical exam.
These recommendations are all part of the Choosing Wisely campaign, a national initiative by medical specialty societies to reduce unnecessary medical care that can actually lead to harm.
How can cancer screening lead to harm?
A positive screening test leads to more testing, like needle biopsies, and even to surgery. These things have complications. And the whole process also causes anxiety and mental suffering. If there is no evidence that screening tests prolong your life when you are older, why set yourself up for that risk?
The only reason to go looking for a diagnosis is to live longer or to feel better. Finding a small, slow-growing cancer when you are 95 is not likely to save your life.
Have a conversation before you have a test.