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Cancer Prevention and Screening for Older Adults: Part 1. Lung,Colorectal, Bladder,and Kidney Cancer
Patrick P. Coll MD AGSF CMD Beatriz Korc-Grodzicki MD PhD AGSF Benjamin T. Ristau MD MHA Armin Shahrokni MD MPH Alexander Koshy MD Olga T. Filippova MD MSc Imran Ali MD MS MPH 《Journal of the American Geriatrics Society》2020,68(10):2399-2406
The incidence of most cancers increases with age. Cancer is the second most common cause of death in older adults after cardiovascular disease. Many common cancers in older adults can be prevented from occurring or can be identified at an early stage and treated effectively. The prevention and identification of cancer in its early stages, in an attempt to reduce discomfort and disability associated with advanced cancer and cancer treatment, is also a priority. Overscreening for cancer in older adults can lead to unnecessary diagnostic testing and unnecessary treatment. Both older adults and their healthcare providers need guidance on the appropriate use of cancer prevention and screening interventions. This first of a two-part review addresses special considerations regarding cancer prevention for adults aged 65 and older. Screening decisions and the impact of limited life expectancy and an older adult's ability to tolerate cancer treatment are also addressed. Guidance is provided regarding the prevention and early identification of lung, colorectal, bladder, and kidney cancer in older adults. The prevention of breast, prostate, and female urogenital cancers are addressed in Part 2. J Am Geriatr Soc 68:2399–2406, 2020. 相似文献
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Timothy W. Farrell MD AGSF Leslie Francis PhD JD Teneille Brown JD Lauren E. Ferrante MD MHS Eric Widera MD Ramona Rhodes MD MPH MSCS AGSF Tony Rosen MD MPH Ula Hwang MD MPH Leah J. Witt MD Niranjan Thothala MD MRCP MBA Shan W. Liu MD SD Caroline A. Vitale MD AGSF Ursula K. Braun MD MPH Caroline Stephens PhD RN GNP-BC Debra Saliba MD MPH AGSF 《Journal of the American Geriatrics Society》2020,68(6):1143-1149
Coronavirus disease 2019 (COVID-19) continues to impact older adults disproportionately with respect to serious consequences ranging from severe illness and hospitalization to increased mortality risk. Concurrently, concerns about potential shortages of healthcare professionals and health supplies to address these issues have focused attention on how these resources are ultimately allocated and used. Some strategies, for example, misguidedly use age as an arbitrary criterion that disfavors older adults in resource allocation decisions. This is a companion article to the American Geriatrics Society (AGS) position statement, “Resource Allocation Strategies and Age-Related Considerations in the COVID-19 Era and Beyond.” It is intended to inform stakeholders including hospitals, health systems, and policymakers about ethical considerations that should be considered when developing strategies for allocation of scarce resources during an emergency involving older adults. This review presents the legal and ethical background for the position statement and discusses these issues that informed the development of the AGS positions: (1) age as a determining factor, (2) age as a tiebreaker, (3) criteria with a differential impact on older adults, (4) individual choices and advance directives, (5) racial/ethnic disparities and resource allocation, and (6) scoring systems and their impact on older adults. It also considers the role of advance directives as expressions of individual preferences in pandemics. J Am Geriatr Soc 68:1143–1149, 2020. 相似文献
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Patrick P. Coll MD AGSF Steven Phu MSc Samah H. Hajjar MBBS Ben Kirk PhD Gustavo Duque MD PhD Pam Taxel MD 《Journal of the American Geriatrics Society》2021,69(5):1388-1398
Osteoporosis and sarcopenia are common in older adults. Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Bone fractures can result in changes in posture, pain, the need for surgical repair and functional impairment. Sarcopenia is the progressive and generalized loss of skeletal muscle mass, strength and/or physical performance. Older adults with sarcopenia experience increased risk of frailty, disability, hospitalizations, mortality, and a reduced quality of life. In this narrative review we provide guidance regarding the prevention of both osteoporosis and sarcopenia, including interventions that prevent both conditions from occurring, recommended screening and treatment to prevent progression. 相似文献
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