The early detection of cancer by screening has been shown to decrease both cancer incidence and cancer mortality and is an important part of primary care practice. There are several important issues to consider when screening for cancer. Are the treatments for cancer acceptable, feasible and effective and for patients in this age group? How often does screening lead to further evaluation, such as breast biopsy after mammography, which may prove unnecessary, yet result in morbidity? Finally,

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... screening improve the quality of life and functional status of older adults? Cancer screening is an evolving technology, and therefore the role that psychologists will play can change with advances in biomedicine. One vital future direction is that the use of risk-stratified screening; potentially reducing harms by targeting screening to groups that stand to achieve more. Screening for certain types of cancer can decrease disease-related mortality. When making any decision about cancer screening, physicians must weigh the risks and benefits for each patient. These risks and benefits include factors such as co-morbid diseases and associated life expectancy, the feasibility of surgical intervention, the acceptability of cancer treatments, and, most important for the elderly, the effects of screening and the resulting diagnostic evaluations and therapies on the quality of life.■