Research and mentoring program in shared decision making in the care of older adults

Adults >75 years are the fastest growing segment of the US population and are increasingly receiving medical interventions from which they often have little chance to benefit, such as cancer screening. Few of the randomized trials of cancer screening tests included adults >75 years and thus the benefits of screening are uncertain; yet, there are important harms which include anxiety, complications as a result of false positive tests and/or work-up of cancer, and overdiagnosis (detection of non-lethal tumors) leading to overtreatment. Guidelines recommend that cancer screening decisions for adults >75 years be individualized based on their risk for cancer, 10-year life expectancy, and values and preferences. Yet, many older adults are screened for cancer with little knowledge of the harms, including many with