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Screening for diseases is accepted as valuable by most physicians and patients. However, screening in patients with terminal illnesses, for whom long-term preventive benefit is nil, would seem to be a needless expense to the healthcare system.
A U.S. national cancer registry and Medicare claims data were merged to explore this issue in 88,000 patients with lung, colorectal, pancreatic, gastroesophageal, or breast cancer whose disease stage predicted 5-year survival of <20%. The cancer patients and a group of matched Medicare patients without known cancer were followed for 9 years or until they died. The 5-year survival rate for the cancer group was <15%, compared with >80% for controls. The screening rate in cancer patients was roughly one t…