Recommendations on cancer prevention, treatment in seniors
LEXINGTON, Ky. (Aug. 28, 2026) — People across the world are mourning the death of Dolly Parton, the country music singer/songwriter who has been a cultural icon for decades. Just a few days prior to her death, Parton said in an interview with People magazine that she was “dealing with some health issues that I just didn’t pay attention to” while caring for her late husband Carl, who died in 2025. This week, Parton’s estate confirmed her cause of death as cancer, though at this time they have not disclosed what type.
Parton’s admission that she overlooked her own health serves as a powerful reminder to be proactive in your healthcare, regardless of age. As a medical oncologist at the University of Kentucky Markey Cancer Center, I treat patients with cancer well into their senior years. In terms of prevention, many screening guidelines include limits on age, but people can develop cancer at any time.
Kentucky has the highest rate of cancer deaths in the country — but many of these cancers are treatable or even preventable through screening.
What are the screening recommendations for older adults?
Recommendations vary by cancer type and the overall health and personal risk factors of the individual. Here are some guidelines to consider.
Lung cancer
We’ll start with the highest burden of cancer in our state: lung cancer. Across the country, only 18% of screening-eligible adults have opted to get screened for lung cancer, which is done with a quick CT scan. The Centers for Disease Control and Prevention (CDC) include all the following factors to recommend lung cancer screening:
-
Age 50-80
-
Have a 20-pack-year or more smoking history (in other words, smoking the equivalent of a pack a day or more for 20 years)
-
Currently smoke now or quit within the past 15 years
Beginning at age 81, the CDC and other national health organizations agree that screenings should stop.
Colorectal cancer
Current recommendations suggest beginning colorectal cancer screening at age 45 and continuing until age 75. However, the CDC suggests patients ages 76-85 speak with their physician about continued screenings, based on past medical history and overall health. Generally speaking, colorectal cancer screenings are not advised over the age of 85.
Breast cancer
Most national health organizations recommend beginning mammograms from ages 40-74 but there are differing opinions on frequency. The U.S. Preventative Services Task Force (USPSTF) recommends a mammogram every two years, while the American Cancer Society recommends more frequent screenings: yearly beginning at age 45 to age 54, with the option to continue yearly thereafter based on medical history and risk.
For patients over the age of 74, there are no set guidelines around continuing screening. Some studies suggest that continuing to screen may not be necessary, as most breast cancers in women over 70 would not grow enough to cause harm. However, a study of women over 80 who continued to get mammograms showed that screenings found more cancers earlier, when treatment was less aggressive; as a result, these patients lived longer.
Because the incidence of this cancer is so high in our state, we recommend shared decision-making between individual patients and their physicians regarding the option to continue screening beyond age 74.
Cervical cancer
There are two tests to help find cervical cancer early: the human papillomavirus (HPV) test, and a Pap smear. The CDC recommends women begin screening with a Pap smear at age 21; if results are normal, their physician may recommend only screening every three years up to age 29.
From age 30-65, your physician may recommend either an HPV test or Pap smear, or both. Depending on which test(s) are done, if the results are normal, they may suggest screenings at 3- or 5-year intervals.
Most national recommendations suggest stopping cervical cancer screening after age 65; however, a 2021 study showed that an estimated 20% of new cervical cancer cases in the U.S. are in women over the age of 65.
In 2006, the U.S. Food and Drug Administration approved the use of Gardasil in adolescents and young adults, an HPV vaccine that helps prevent cervical and other gynecological or genital cancers. However, older generations did not have access to this vaccine, and those over 65 may remain at an increased risk for cervical cancer. Speak with your physician about their recommendations for cervical screenings from mid-60s and beyond.
Prostate cancer
Although there is no recommended standard screening for prostate cancer, the most common test used is a prostate specific antigen (PSA) blood test, which measures the amount of PSA in the blood. A higher level of PSA may indicate an issue with the prostate, but PSA can be affected by many factors, like medical procedures or medications. As such, it is a less reliable indicator of cancer than other types of screenings, but currently it’s the best option available.
The CDC and USPSTF both recommend men ages 55-69 discuss the option of PSA tests with their physician. Patients who have a higher risk for the disease — such as a family history, ethnicity and lifestyle — may be more suited to regular screenings with PSA tests. The most common form of prostate cancer is slow-growing, and these organizations do not recommend PSA tests for men 70 and over because the potential harms outweigh the benefits.
Ovarian cancer
Currently, there are no national guidelines supporting screening for ovarian cancer for people who have no symptoms. However, ovarian cancer is more deadly than any other type of gynecologic cancer, and it typically causes no symptoms until the cancer is very advanced. Through the UK Markey Cancer Center Ovarian Cancer Screening Program, Kentucky women age 50 and older (or 25 and older if high-risk) are eligible to receive free screenings for ovarian cancer.
Should I receive cancer treatment if I’m older?
Patients who are diagnosed in their 70s, 80s, even 90s may not wish to undergo cancer treatment — and that’s understandable. However, many older patients are not even offered treatment like chemotherapy as an option, because the treating physician may assume they don’t want the treatment or don’t think the patient will do well.
I think it’s important to not focus solely on a person’s chronological age. If the patient is otherwise in good health, has good organ function, and is willing to undergo treatment, it’s worth having that conversation about their options. It is also important to know that a lot of treatments now being used for cancer, including immunotherapy and small molecule inhibitors, are very well tolerated by older people. It’s an option they definitely do not want to miss.
One of my studies focused on how age impacts patient care. We looked at outcomes for 3,000 nonsmall cell lung cancer patients over 80. As suspected, a majority did not get any treatment. But those that did got just as much benefit as younger people. If they are healthy enough to participate in a clinical trial, I tell my patients over 80, “We’re going to let you try.” We have spent so much time developing wonderful trials and drugs. Everyone who could benefit from them should get that opportunity.
UK HealthCare is the hospitals and clinics of the University of Kentucky. But it is so much more. It is more than 10,000 dedicated healthcare professionals committed to providing advanced subspecialty care for the most critically injured and ill patients from the Commonwealth and beyond. It also is the home of the state’s only National Cancer Institute (NCI)-designated Comprehensive Cancer Center, a Level IV Neonatal Intensive Care Unit that cares for the tiniest and sickest newborns and the region’s only Level 1 trauma center.
As an academic research institution, we are continuously pursuing the next generation of cures, treatments, protocols and policies. Our discoveries have the potential to change what’s medically possible within our lifetimes. Our educators and thought leaders are transforming the healthcare landscape as our six health professions colleges teach the next generation of doctors, nurses, pharmacists and other healthcare professionals, spreading the highest standards of care. UK HealthCare is the power of advanced medicine committed to creating a healthier Kentucky, now and for generations to come.