ASPO Abstracts
Aversion to ambiguity of cancer screening and perceived benefits of mammography in a racially diverse sample of women
Category: Behavioral Science & Health Communication
Conference Year: 2019
Abstract Body:
Purpose: Breast cancer screening guidelines have become increasingly complex and focus on personalized screening based on personal risk and preferences. This requires women to consider uncertain and conflicting recommendations to make screening decisions. Differences in aversion to ambiguous medical information may influence perception of mammography benefits, but this has not been adequately investigated amongst racial/ethnic minority women. We examined the association of aversion to ambiguity (AA) regarding cancer screening test with benefits of mammography (BoM) screening, and demographic variables in women of diverse ethnic and predominantly immigrant backgrounds. Methods: We used interview data from 686 women, aged 40-60 years, recruited during mammography appointments in NYC (78% Hispanic, 11% non-Hispanic black; 77% foreign-born). AA was measured using a 6-item scale capturing agreement with statements about obtaining a cancer screening test with conflicting recommendations (e.g., “Would avoid making a decision about the test”). The perceived BoM screening was measured using a scale representing perceptions of positive outcomes of mammogram (e.g., “Having a mammogram will help me find breast lumps early”). Multivariable linear regression models were used to assess the association between the BoM score, AA, age, nativity status, and education level. Results: AA was lower in women who were foreign-born, Hispanic, older and had lower educational attainment. In models adjusting for these characteristics, higher AA was associated with lower perceived BoM (β=-0.3, 95%CI -0.6-0.0). Specifically, women who expressed willingness to receive ambiguous cancer screening test were significantly more likely to endorse perceived mammography screening benefits (β=0.8, 95%CI: 0.3-1.3). Foreign born women reported higher perceived BoM than US born women (β=0.7, 95%CI 0.4-1.1) after adjusting for differences in AA. Conclusions: Perceived BoM are associated with less aversion to ambiguous medical information and with willingness to undergo screening despite conflicting recommendations. In the growing discussion of uncertainty of breast cancer screening, aversion to medical ambiguity ambiguity may have important implications for making personalized screening plans.
Keywords: Medical Ambiguity, Breast Cancer, Personalized Screening