Examining Older Adults' Attitudes and Perceptions Towards Cancer Screening and Overscreening

Authors: Roy S, Moss JL, Rodriguez-Colon SM, Shen C, Cooper JD, Lengerich EJ, Adelman A, Curry W, Ruffin MT

Category: Behavioral Science & Health Communication
Conference Year: 2020

Abstract Body:
Introduction (Purpose): The U.S. Preventive Services Task Force (USPSTF) guidelines recommend patients stop screening for breast, cervical, and colorectal cancers based on age or health status. Understanding how older adults perceive cancer screening will help facilitate screening decisions for these cancers and reduce overscreening. The purpose of this study was to examine attitudes and perceptions of older adults regarding cancer screening, specifically related to breast, cervical, and colorectal cancers. Methods: Four focus groups (N= 39) were conducted in two community, urban settings in southeastern Pennsylvania. Study flyers and one-page descriptions were used to recruit participants at community and senior centers. Inclusion criteria consisted of: 1) 65 years of age and older; 2) Not currently being treated for a cancer diagnosis; 3) Not diagnosed with cancer (excluding skin cancer) in the past 5 years; 4) Able to speak, read, and write English and 5) Living independently or in assisted living facility. Inductive thematic analysis was used to analyze the data. Results: The majority of participants were female (74%), Hispanic (69%), and White (56%) with an average age of 74. Results showed that older adults desired tailored information based on individual/family health history and current health status to make a decision about cancer screening. They also valued their physician's recommendation regarding screening but required their physician to justify individual recommendations to stop screening. Overall, attitudes regarding stopping screening among participants varied, ranging from hesitancy due to their awareness of the benefits of screening to eagerness due to previous negative experiences regarding screening (pain, stress, etc.). Conclusions: Multiple factors contribute to a decision by older adults to stop or continue periodic cancer screening. Stopping cancer screening requires giving older adults individualized information on the benefits and risks from screening and how these change with age and health status. Future research should further examine the content, method and timing of patient/provider communication in cancer screening decisions among older adults.

Keywords: overscreening, qualitative, older adults