Preferences for Communicating about Breast Cancer Screening Among Racially/Ethnically Diverse Older Women

ABSTRACT

Differences exist across breast cancer screening guidelines regarding frequency of screening and age of discontinuation for older women (≥70 years) at average risk for breast cancer. These differences highlight concerns about the benefits and harms of screening, and may negatively impact older women’s ability to make informed screening decisions. This study examined preferences for communicating about screening mammography among racially/ethnically diverse, older women. In-depth interviews were conducted with 59 women with no breast cancer history. Non-proportional quota sampling ensured roughly equal numbers on age (70–74 years, ≥75 years), race/ethnicity (non-Hispanic/Latina White, non-Hispanic/Latina Black, Hispanic/Latina), and education (≤high school diploma, >high school diploma). Interviews were audio-recorded, transcribed, and analyzed using NVivo 10. Thematic analyses revealed that rather than being told to get mammograms, participants wanted to hear about the benefits and harms of screening mammography, including overdiagnosis. Participants recommended that this information be communicated via physicians or other healthcare providers, included in brochures/pamphlets, and presented outside of clinical settings (e.g., in senior groups). Results were consistent regardless of participants’ age, race/ethnicity, or education. Findings revealed that older women desire information about the benefits and harms of screening mammography, and would prefer to learn this information through discussions with healthcare providers and multiple other formats.

Additional information

Funding

This research was supported by the Agency for Healthcare Research and Quality [R24 HS022134 to JSG]; the Cancer Prevention and Research Institute of Texas [RP160674 to JSG]; the National Cancer Institute at the National Institutes of Health [P30 CA016672 to University of Texas MD Anderson Cancer Center as a Cancer Center Support Grant, R25T CA57730 (PI: Shine Chang) to AJH, and K05 CA134923 to JSG]; the National Institute on Drug Abuse at the National Institutes of Health [K23 DA040933 to DSH]; the National Institute on Aging [P30 AG024832 (PI: Elena Volpi) to MRP]; the National Institute on Disability, Independent Living and Rehabilitation Research [90AR5009 (PI: Ken Ottenbacher) and 90SFGE0002 to SK]; and The University of Texas MD Anderson Cancer Center’s Duncan Family Institute for Cancer Prevention and Risk Assessment.