ArticlemedRxiv : the preprint server for health sciences2025
Understanding motivations of older women to continue or discontinue breast cancer screening.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Breast cancer screening guidelines indicate screening in women over 75 years of age is optional, depending upon patient health and preferences. Objectives: To link experiences and perceptions of older women concerning screening to their intention to continue or discontinue screening. Design: Qualitative comparative study, comparing continuers and discontinuers. Setting: Community-residing adults. Participants: A purposive sample (n=59) with equal representation of White, Black, and Hispanic women by age (70-74 years and 75 and older) and educational level (≤12 grade and >12 grade). Measurements: In-depth qualitative interviews explored women's perceptions of mammograms, the benefits and risks of screening, and personal screening experiences. Interviews were coded and quality-checked by two or more coders. A qualitative comparative analysis (QCA) was used to identify combinations of personal characteristics and themes linked to the intention to continue (n=32) or discontinue (n=27) screening. Results: Personal experience themes were strongly linked to the intention to continue or discontinue. Women who mentioned recent screening (within three years) and either a spontaneously mentioned cancer story concerning a friend or family member or a doctor's screening recommendation intended to continue screening (91% true positive rate, model sensitivity). Women who did not schedule screening and who did not mention a cancer story or a doctor's recommendation (or neither) intended to discontinue screening (81% true negative rate, model specificity). These themes transcended differences in race/ethnicity, age, and educational level. Conclusion: Continuation of breast cancer screening in older women is motivated by their personal screening history combined with cancer experiences and/or a doctor's screening recommendation.
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