Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Nonadherence to Cancer Screenings & Related Mortality

JAMA Intern Med; ePub 2018 Dec 28; Pierre-Victor, et al

Among middle-aged and older adults in a screening trial for multiple cancers, nonadherence to cancer screening tests was associated with increased mortality, a recent study found. The secondary analysis included 64,567 men and women (mean age 62.3 years) in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening trial and researchers evaluated the association between nonadherence to cancer screening tests and mortality, excluding mortality from cancers studied in the trial. They found:

  • Overall, 55,065 participants (85.3%) were adherent, 2,548 (3.9%) were partially adherent, and 6,954 (10.8%) were nonadherent with the baseline screening protocol.
  • Within 10 years of follow-up, the hazard ratio (HR) of mortality was 1.73 for nonadherent compared with fully adherent participants and 1.36 for partially compared with fully adherent participants.
  • Nonadherent participants experienced higher rates of mortality from unrelated causes.


Pierre-Victor D, Pinsky PF. Association of nonadherence to cancer screening examinations with mortality from unrelated causes: A secondary analysis of the PLCO Cancer Screening Trial. [Published online ahead of print December 28, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.5982.

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