Too old to be screened for cancer

BarcelonaIn two court rulings, Joaquim Vilargunter obtained a response to the ageism complaint he had filed against the Catalan Health Service (CatSalut). This Barcelona lawyer took the colon cancer screening program to court because it excludes people over 69 years of age. He felt discriminated against because of his age and requested that the public health system extend the early detection test for the tumor, which has a higher incidence in men and women, to age 74, according to statistics from the Department of Health. "I have the right, and I justified it by providing European health guidelines that recommend expanding the target age group," he explained in a conversation at his home. Indeed, in the Basque Country, the target population for hescreening is between 50 and 74 years old, the same age range as in other European Union countries. "I do it because after 69, illnesses and the likelihood of suffering from cancer don't disappear; on the contrary," she argues.

But the court didn't side with her and dismissed the complaint. She had previously received the same negative response from CatSalut to her request through administrative channels. Aware that court deadlines can drag on, she requested, as a precautionary measure, entry into the program past the age of 69 while she awaited a ruling. The screening test consists of a stool sample to rule out the presence of blood traces that could hide a lesion or tumor in the patient's colon and rectum. "It's a very cheap test that can prevent a potentially fatal disease from being treated more expensively and more aggressively," she explains, and criticizes "institutional ageism" in an area as delicate as health.

In fact, colorectal is not the only early diagnosis in which the patient's age is limited: Mammograms are also performed between the ages of 50 and 69. And the cutoff age for cervical cancer screening is 65. Although there are no set age limits in banking, institutions follow ageist criteria when granting mortgages, such as requiring them to close before the holder turns 70, and health insurance policies require doctors to cover them. "These are cases that everyone accepts and, therefore, often go unnoticed," emphasizes Lourdes Charles, co-founder of Somos Seniors, which seeks to change the way we view old age.

Paying the costs of the process

Last July, Barcelona's 8th Administrative Court informed Vilargunter that it was refusing him entry into the screening program as a precautionary measure. But that wasn't the only defeat. The judge ordered him to pay €300 in court costs. With this ruling, his only option is to appeal to a higher court; a step he almost rules out due to the financial cost of embarking on the case and also because, at 72, if they ruled in his favor, he estimates he'd be 74 or older and would once again be excluded from the public plan.

Vilargunter insists that automatically excluding people at age 69 "does not respond to updated medical criteria" but, on the contrary, complies with outdated medical literature and "disregards" the value of prevention in older people. Considering that the older we get, the greater the risk of disease, he points out that a simple stool test "could save lives" and prevent more suffering than necessary. "Basically, they tell you that you can die, that the administration has the power to decide when people have rights or cease to have them, because after 69, it's time for adventure," he reflects. He believes that all of this is due more to "the negligence" of the health authorities than to scientific rigor.

The judge understands the claim, but reasons that the procedure has not proven what irreparable harm would result from not performing the test immediately and rules out periculum in mora, that is, there is a danger in delaying its inclusion in the screening program again.