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Resistance to discontinuing breast cancer screening in older women: A qualitative study
Author(s) -
Housten Ashley J.,
Pappadis Monique R.,
Krishnan Shilpa,
Weller Susan C.,
Giordano Sharon H.,
Bevers Therese B.,
Volk Robert J.,
Hoover Diana S.
Publication year - 2018
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.4708
Subject(s) - medicine , breast cancer screening , breast cancer , family medicine , life expectancy , qualitative research , cancer screening , mammography , ethnic group , government (linguistics) , gerontology , cancer , environmental health , population , social science , linguistics , philosophy , sociology , anthropology
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.