Older adults' interest and concerns about life expectancy information for cancer screening decisions: Results from the National Poll on Healthy Aging.

Objective: Life expectancy is a more nuanced metric than age by which to weigh the risks, harms, and benefits of different preventive care tests and interventions. This study characterized older adults' attitudes and beliefs regarding life expectancy information and the acceptability of its use in decisions about cancer screening. Methods: Data were collected in January 2023 as part of the University of Michigan National Poll on Healthy Aging, a recurring, nationally representative household survey of adults in the United States. Results: Respondents were 1298 older adults ages 65 to 80 years (mean age = 70.9; 675 [52 %] male, 754 [58 %] White). Although 61.3 % of respondents were interested in knowing their life expectancy and 62.3 % believed knowing how much longer they are likely to live would help them make better health decisions, very few (4.5 %) had ever discussed their life expectancy with a provider. Older adults found it more acceptable for a provider to bring up life expectancy when recommending continuing (85.6 %) than stopping cancer screening (47.2 %). More men than women were interested in knowing their life expectancy (66.5 % vs. 56.9 %, p < .01) and believed knowing their life expectancy would help them make better health decisions (67.1 % vs. 58.2 %, p < .01). Conclusions: Most older adults were interested in knowing their estimated life expectancy, but few are having conversations about it with healthcare providers or to inform cancer screening decisions. Further efforts are needed to improve patient-provider consideration of and discussion about life expectancy as a component of informed medical decision making.