Ashley J Housten1, Monique R Pappadis2,3, Shilpa Krishnan3,4, Susan C Weller3,5,6, Sharon H Giordano1, Therese B Bevers7, Robert J Volk1, Diana S Hoover8. 1. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 2. Division of Rehabilitation Sciences, School of Health Professions, The University of Texas Medical Branch, Galveston, TX, USA. 3. Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, USA. 4. Department of Occupational Therapy, School of Health Professions, The University of Texas Medical Branch, Galveston, TX, USA. 5. Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX, USA. 6. Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA. 7. Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 8. Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Abstract
OBJECTIVE: Screening mammography is associated with reduced breast cancer-specific mortality; however, among older women, evidence suggests that the potential harms of screening may outweigh the benefits. We used a qualitative approach to examine the willingness of older women from different racial/ethnic groups to discontinue breast cancer screening. METHODS: Women ≥70 years of age who reported having a screening mammogram in the past 3 years and/or reported that they intended to continue screening in the future were recruited for in-depth interviews. Participants who intended to continue screening were asked to describe how the following hypothetical scenarios would impact a decision to discontinue screening: health concerns or limited life expectancy, a physician's recommendation to discontinue, reluctance to undergo treatment, and recommendations from experts or governmental panels to stop screening. Semi-structured, face-to-face interviews were audio-recorded. Data coding and analysis followed inductive and deductive approaches. RESULTS: Regardless of the scenario, participants (n = 29) expressed a strong intention to continue screening. Based on the hypothetical physician recommendations, intentions to continue screening appeared to remain strong. They did not envision a change in their health status that would lead them to discontinue screening and were skeptical of expert/government recommendations. There were no differences observed according to age, race/ethnicity, or education. CONCLUSIONS: Among older women who planned to continue screening, intentions to continue breast cancer screening appear to be highly resilient and resistant to recommendations from physicians or expert/government panels.
OBJECTIVE: Screening mammography is associated with reduced breast cancer-specific mortality; however, among older women, evidence suggests that the potential harms of screening may outweigh the benefits. We used a qualitative approach to examine the willingness of older women from different racial/ethnic groups to discontinue breast cancer screening. METHODS:Women ≥70 years of age who reported having a screening mammogram in the past 3 years and/or reported that they intended to continue screening in the future were recruited for in-depth interviews. Participants who intended to continue screening were asked to describe how the following hypothetical scenarios would impact a decision to discontinue screening: health concerns or limited life expectancy, a physician's recommendation to discontinue, reluctance to undergo treatment, and recommendations from experts or governmental panels to stop screening. Semi-structured, face-to-face interviews were audio-recorded. Data coding and analysis followed inductive and deductive approaches. RESULTS: Regardless of the scenario, participants (n = 29) expressed a strong intention to continue screening. Based on the hypothetical physician recommendations, intentions to continue screening appeared to remain strong. They did not envision a change in their health status that would lead them to discontinue screening and were skeptical of expert/government recommendations. There were no differences observed according to age, race/ethnicity, or education. CONCLUSIONS: Among older women who planned to continue screening, intentions to continue breast cancer screening appear to be highly resilient and resistant to recommendations from physicians or expert/government panels.
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