Which screening test is not recommended for cancer screening in older adults?

• A. Serum cancer marker testing annually
• B. Colonoscopy every 2 years
• C. Flexible sigmoidoscopy every 4 years
• D. Fecal occult blood screening annually

Answer: (A)

Screening tests for cancer in older adults should be proven to improve outcomes and have reliable accuracy. Serum cancer marker testing done annually does not meet that standard because these markers often lack sufficient sensitivity and specificity in asymptomatic people, can be elevated for noncancerous reasons, and, when positive, lead to additional invasive procedures that carry risks for older adults without proven mortality benefit. In contrast, established screening methods like colonoscopy, flexible sigmoidoscopy, and fecal occult blood testing have guideline-supported roles and intervals, making them the preferred options when screening is appropriate.