Resistance to discontinuing breast cancer screening in older women: A qualitative study

Psychooncology. 2018 Jun;27(6):1635-1641. doi: 10.1002/pon.4708. Epub 2018 Apr 17.

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.

Keywords: aged; breast; cancer; cultural diversity; early detection of cancer; oncology; qualitative; race/ethnicity; women.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / prevention & control
  • Breast Neoplasms / psychology*
  • Decision Making*
  • Early Detection of Cancer / psychology
  • Female
  • Health Status
  • Humans
  • Life Expectancy
  • Mammography / psychology*
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • Qualitative Research