TY - JOUR
T1 - Psychosocial and clinical predictors of continued cancer screening in older adults
AU - Smith, J.
AU - Dodd, R.H.
AU - Hersch, J.
AU - McCaffery, K.J.
AU - Naganathan, V.
AU - Cvejic, E.
AU - Jansen, J.
N1 - Funding Information:
This work was supported by an Australian NHMRC Program Grant ( APP1113532 ) and NHMRC CDF Fellowship ( APP1162149 ).
Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Objective: Many older adults (aged 75+) continue cancer screening despite guidelines suggesting they should not. Using mixed-methods, we examined psychosocial and clinical factors associated with continued breast/prostate screening. Methods: We conducted an online, scenario-based, randomized study in Australia with participants aged 65+ years. The primary outcome was screening intention (10-point scale, dichotomized: low (1-5) and high (6-10)). We also measured demographic, psychosocial, and age-related clinical variables. Participants provided reason/s for their screening intentions in free-text. Results: 271 eligible participants completed the survey (aged 65-90 years, 71% adequate health literacy). Those who reported higher cancer anxiety, were men, screened more recently, had family history of breast/ prostate cancer and were independent in activities of daily living, were more likely to intend to continue screening. Commonly reported reasons for intending to continue screening were grouped into six themes: routine adherence, the value of knowing, positive screening attitudes, perceived susceptibility, benefits focus, and needing reassurance. Conclusions: Psychosocial factors may drive continued cancer screening in older adults and undermine efforts to promote informed decision-making. Practice implications: When communicating benefits and harms of cancer screening to older adults, both clinical and psychosocial factors should be discussed to support informed decision-making. (c) 2021 Elsevier B.V. All rights reserved.
AB - Objective: Many older adults (aged 75+) continue cancer screening despite guidelines suggesting they should not. Using mixed-methods, we examined psychosocial and clinical factors associated with continued breast/prostate screening. Methods: We conducted an online, scenario-based, randomized study in Australia with participants aged 65+ years. The primary outcome was screening intention (10-point scale, dichotomized: low (1-5) and high (6-10)). We also measured demographic, psychosocial, and age-related clinical variables. Participants provided reason/s for their screening intentions in free-text. Results: 271 eligible participants completed the survey (aged 65-90 years, 71% adequate health literacy). Those who reported higher cancer anxiety, were men, screened more recently, had family history of breast/ prostate cancer and were independent in activities of daily living, were more likely to intend to continue screening. Commonly reported reasons for intending to continue screening were grouped into six themes: routine adherence, the value of knowing, positive screening attitudes, perceived susceptibility, benefits focus, and needing reassurance. Conclusions: Psychosocial factors may drive continued cancer screening in older adults and undermine efforts to promote informed decision-making. Practice implications: When communicating benefits and harms of cancer screening to older adults, both clinical and psychosocial factors should be discussed to support informed decision-making. (c) 2021 Elsevier B.V. All rights reserved.
KW - Older adults
KW - Breast cancer screening
KW - Prostate cancer screening
KW - Overdiagnosis
KW - Informed decision-making
U2 - 10.1016/j.pec.2021.04.027
DO - 10.1016/j.pec.2021.04.027
M3 - Article
C2 - 33962825
SN - 0738-3991
VL - 104
SP - 3093
EP - 3096
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 12
ER -