RT Journal
A1 Cunningham J
T1 DIscussing cancer screening with elderly patients
JF JAMA
JO JAMA
YR 2001
FD September 12
VO 286
IS 10
SP 1175
OP 1176
DO 10.1001/jama.286.10.1173
UL http://dx.doi.org/10.1001/jama.286.10.1173
AB 
Although it is generally thought that screening interventions should
be judged by their effect on mortality, patients may have other reasons for
seeking such tests. For example, imagine a patient who will die in 5 years,
with or without screening for breast cancer. But, if in one scenario she will
die in her sleep and if in the other die of painful metastatic breast cancer,
she may well see an advantage to having the breast cancer diagnosed and treated,
even if there is no survival benefit. Realistic estimates of the harms of
the disease itself also need to be discussed with patients when providing
information for the screening decision.