TY - JOUR
T1 - Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA
T2 - A mixed-methods analysis
AU - Pappadis, Monique R.
AU - Volk, Robert J.
AU - Krishnan, Shilpa
AU - Weller, Susan C.
AU - Jaramillo, Elizabeth
AU - Hoover, Diana Stewart
AU - Giordano, Sharon H.
AU - Tan, Alai
AU - Sheffield, Kristin M.
AU - Housten, Ashley J.
AU - Goodwin, James S.
N1 - Funding Information:
funding This work was supported by the Agency for Healthcare Research and Quality (AHRQ) (grant number R24 HS022134); the National Institute on Aging (NIA) (grant number P30 AG024832); the Cancer Prevention and Research Institute of Texas (CPRIT) (grant number RP160674); the National Cancer Institute (NCI) (grant number K05 CA13492; R25T CA5773); the National Institute on Minority Health and Health Disparities (NIMHD) (L60 MD009326; K99MD011485); the Cancer Center Support Grant to The University of Texas MD Anderson Cancer Center (grant number P30 CA016672); the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) (grant number 90AR5009; 90SFGE0002; the National Institute on Drug Abuse (NIDA) (grant number K23 DA040933); and The University of Texas MD Anderson Cancer Center’s Duncan Family Institute for Cancer Prevention and Risk Assessment. Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the AHRQ, NIA, NCI, NIMHD, NIDILRR or NIDA. Competing interests None declared.
Funding Information:
This work was supported by the Agency for Healthcare Research and Quality (AHRQ) (grant number R24 HS022134); the National Institute on Aging (NIA) (grant number P30 AG024832); the Cancer Prevention and Research Institute of Texas (CPRIT) (grant number RP160674); the National Cancer Institute (NCI) (grant number K05 CA13492; R25T CA5773); the National Institute on Minority Health and Health Disparities (NIMHD) (L60 MD009326; K99MD011485); the Cancer Center Support Grant to The University of Texas MD Anderson Cancer Center (grant number P30 CA016672); the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) (grant number 90AR5009; 90SFGE0002; the National Institute on Drug Abuse (NIDA) (grant number K23 DA040933); and The University of Texas MD Anderson Cancer Center's Duncan Family Institute for Cancer Prevention and Risk Assessment.
Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Objectives Current research on the perceptions of overdiagnosis or overdetection of breast cancer has largely been conducted outside of the USA and with women younger than 70 years. Therefore, we explored older women's perceptions about the concept of overdetection of breast cancer and its influence on future screening intentions. Design Mixed-methods analysis using purposive sampling based on race/ethnicity, age and educational level. Semistructured interviews, including two hypothetical scenarios illustrating benefits and harms of screening and overdetection, were analysed using inductive and deductive thematic approaches. An inferential clustering technique was used to assess overall patterns in narrative content by sociodemographic characteristics, personal screening preferences or understanding of overdetection. Setting Houston/Galveston, Texas, USA. Participants 59 English-speaking women aged 70 years and older with no prior history of breast cancer. Results Very few women were familiar with the concept of overdetection and overtreatment. After the scenarios were presented, half of the women still demonstrated a lack of understanding of the concept of overdetection. Many women expressed suspicion of the concept, equating it to rationing. Women who showed understanding of overdetection were more likely to express an intent to discontinue screening, although 86% of the women stated that hearing about overdetection did not influence their screening decision. Themes identified did not differ by race/ethnicity, education, age or screening preferences. Differences were identified between women who understood overdetection and women who did not (r=0.23, p<0.001). Conclusions Many older women did not understand the concept of overdetection, in addition to being suspicious of or resistant to the concept. Providing older women with descriptions of overdetection may not be sufficient to influence screening intentions.
AB - Objectives Current research on the perceptions of overdiagnosis or overdetection of breast cancer has largely been conducted outside of the USA and with women younger than 70 years. Therefore, we explored older women's perceptions about the concept of overdetection of breast cancer and its influence on future screening intentions. Design Mixed-methods analysis using purposive sampling based on race/ethnicity, age and educational level. Semistructured interviews, including two hypothetical scenarios illustrating benefits and harms of screening and overdetection, were analysed using inductive and deductive thematic approaches. An inferential clustering technique was used to assess overall patterns in narrative content by sociodemographic characteristics, personal screening preferences or understanding of overdetection. Setting Houston/Galveston, Texas, USA. Participants 59 English-speaking women aged 70 years and older with no prior history of breast cancer. Results Very few women were familiar with the concept of overdetection and overtreatment. After the scenarios were presented, half of the women still demonstrated a lack of understanding of the concept of overdetection. Many women expressed suspicion of the concept, equating it to rationing. Women who showed understanding of overdetection were more likely to express an intent to discontinue screening, although 86% of the women stated that hearing about overdetection did not influence their screening decision. Themes identified did not differ by race/ethnicity, education, age or screening preferences. Differences were identified between women who understood overdetection and women who did not (r=0.23, p<0.001). Conclusions Many older women did not understand the concept of overdetection, in addition to being suspicious of or resistant to the concept. Providing older women with descriptions of overdetection may not be sufficient to influence screening intentions.
UR - http://www.scopus.com/inward/record.url?scp=85053151391&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-022138
DO - 10.1136/bmjopen-2018-022138
M3 - Article
C2 - 29903800
AN - SCOPUS:85053151391
VL - 8
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 6
M1 - e022138
ER -