Psychosocial and clinical predictors of continued cancer screening in older adults
•We describe factors influencing older adults’ cancer screening decisions.•Important factors are cancer anxiety, screening enthusiasm, routine adherence.•These factors undermine efforts to promote informed decision-making.•Clinicians may need to address cancer anxiety in screening discussions. Many...
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Veröffentlicht in: | Patient education and counseling 2021-12, Vol.104 (12), p.3093-3096 |
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creator | Smith, Jenna Dodd, Rachael H. Hersch, Jolyn McCaffery, Kirsten J. Naganathan, Vasi Cvejic, Erin Jansen, Jesse |
description | •We describe factors influencing older adults’ cancer screening decisions.•Important factors are cancer anxiety, screening enthusiasm, routine adherence.•These factors undermine efforts to promote informed decision-making.•Clinicians may need to address cancer anxiety in screening discussions.
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.
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.
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.
Psychosocial factors may drive continued cancer screening in older adults and undermine efforts to promote informed decision-making.
When communicating benefits and harms of cancer screening to older adults, both clinical and psychosocial factors should be discussed to support informed decision-making. |
doi_str_mv | 10.1016/j.pec.2021.04.027 |
format | Article |
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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.
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.
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.
Psychosocial factors may drive continued cancer screening in older adults and undermine efforts to promote informed decision-making.
When communicating benefits and harms of cancer screening to older adults, both clinical and psychosocial factors should be discussed to support informed decision-making.</description><identifier>ISSN: 0738-3991</identifier><identifier>EISSN: 1873-5134</identifier><identifier>DOI: 10.1016/j.pec.2021.04.027</identifier><identifier>PMID: 33962825</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Activities of Daily Living ; Aged ; Breast cancer screening ; Decision Making ; Early Detection of Cancer ; Humans ; Informed decision-making ; Male ; Mass Screening ; Older adults ; Overdiagnosis ; Prostate cancer screening ; Prostatic Neoplasms - diagnosis</subject><ispartof>Patient education and counseling, 2021-12, Vol.104 (12), p.3093-3096</ispartof><rights>2021 Elsevier B.V.</rights><rights>Copyright © 2021 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-3c211e0c356d3a4f9ada19fd05b0f9305224569202a8522d4cde41b424c9cb583</citedby><cites>FETCH-LOGICAL-c353t-3c211e0c356d3a4f9ada19fd05b0f9305224569202a8522d4cde41b424c9cb583</cites><orcidid>0000-0001-5225-6639</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0738399121002925$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33962825$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smith, Jenna</creatorcontrib><creatorcontrib>Dodd, Rachael H.</creatorcontrib><creatorcontrib>Hersch, Jolyn</creatorcontrib><creatorcontrib>McCaffery, Kirsten J.</creatorcontrib><creatorcontrib>Naganathan, Vasi</creatorcontrib><creatorcontrib>Cvejic, Erin</creatorcontrib><creatorcontrib>Jansen, Jesse</creatorcontrib><title>Psychosocial and clinical predictors of continued cancer screening in older adults</title><title>Patient education and counseling</title><addtitle>Patient Educ Couns</addtitle><description>•We describe factors influencing older adults’ cancer screening decisions.•Important factors are cancer anxiety, screening enthusiasm, routine adherence.•These factors undermine efforts to promote informed decision-making.•Clinicians may need to address cancer anxiety in screening discussions.
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.
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.
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.
Psychosocial factors may drive continued cancer screening in older adults and undermine efforts to promote informed decision-making.
When communicating benefits and harms of cancer screening to older adults, both clinical and psychosocial factors should be discussed to support informed decision-making.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Breast cancer screening</subject><subject>Decision Making</subject><subject>Early Detection of Cancer</subject><subject>Humans</subject><subject>Informed decision-making</subject><subject>Male</subject><subject>Mass Screening</subject><subject>Older adults</subject><subject>Overdiagnosis</subject><subject>Prostate cancer screening</subject><subject>Prostatic Neoplasms - diagnosis</subject><issn>0738-3991</issn><issn>1873-5134</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMouq7-AC_So5fWfHZbPIn4BQuK6Dmkk6lm6SZr0gr-eyOrHj0lMzzzwvsQcsJoxSirz1fVBqHilLOKyoryxQ6ZsWYhSsWE3CUzuhBNKdqWHZDDlFaU0rqWbJ8cCNHWvOFqRp4e0ye8hRTAmaEw3hYwOO8gD5uI1sEYYipCX0Dwo_MTZsB4wFgkiIje-dfC-SIMNq-MnYYxHZG93gwJj3_eOXm5uX6-uiuXD7f3V5fLEoQSYymAM4Y0D7UVRvatsYa1vaWqo30rqOJcqrrN7UyT_1aCRck6ySW00KlGzMnZNncTw_uEadRrlwCHwXgMU9JccSlUbllnlG1RiCGliL3eRLc28VMzqr9V6pXOKvW3Sk2lzirzzelP_NSt0f5d_LrLwMUWwFzyw2HUCRxmN9ZFhFHb4P6J_wIPvYQN</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Smith, Jenna</creator><creator>Dodd, Rachael H.</creator><creator>Hersch, Jolyn</creator><creator>McCaffery, Kirsten J.</creator><creator>Naganathan, Vasi</creator><creator>Cvejic, Erin</creator><creator>Jansen, Jesse</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5225-6639</orcidid></search><sort><creationdate>202112</creationdate><title>Psychosocial and clinical predictors of continued cancer screening in older adults</title><author>Smith, Jenna ; Dodd, Rachael H. ; Hersch, Jolyn ; McCaffery, Kirsten J. ; Naganathan, Vasi ; Cvejic, Erin ; Jansen, Jesse</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-3c211e0c356d3a4f9ada19fd05b0f9305224569202a8522d4cde41b424c9cb583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Breast cancer screening</topic><topic>Decision Making</topic><topic>Early Detection of Cancer</topic><topic>Humans</topic><topic>Informed decision-making</topic><topic>Male</topic><topic>Mass Screening</topic><topic>Older adults</topic><topic>Overdiagnosis</topic><topic>Prostate cancer screening</topic><topic>Prostatic Neoplasms - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smith, Jenna</creatorcontrib><creatorcontrib>Dodd, Rachael H.</creatorcontrib><creatorcontrib>Hersch, Jolyn</creatorcontrib><creatorcontrib>McCaffery, Kirsten J.</creatorcontrib><creatorcontrib>Naganathan, Vasi</creatorcontrib><creatorcontrib>Cvejic, Erin</creatorcontrib><creatorcontrib>Jansen, Jesse</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Patient education and counseling</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smith, Jenna</au><au>Dodd, Rachael H.</au><au>Hersch, Jolyn</au><au>McCaffery, Kirsten J.</au><au>Naganathan, Vasi</au><au>Cvejic, Erin</au><au>Jansen, Jesse</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psychosocial and clinical predictors of continued cancer screening in older adults</atitle><jtitle>Patient education and counseling</jtitle><addtitle>Patient Educ Couns</addtitle><date>2021-12</date><risdate>2021</risdate><volume>104</volume><issue>12</issue><spage>3093</spage><epage>3096</epage><pages>3093-3096</pages><issn>0738-3991</issn><eissn>1873-5134</eissn><abstract>•We describe factors influencing older adults’ cancer screening decisions.•Important factors are cancer anxiety, screening enthusiasm, routine adherence.•These factors undermine efforts to promote informed decision-making.•Clinicians may need to address cancer anxiety in screening discussions.
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.
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.
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.
Psychosocial factors may drive continued cancer screening in older adults and undermine efforts to promote informed decision-making.
When communicating benefits and harms of cancer screening to older adults, both clinical and psychosocial factors should be discussed to support informed decision-making.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>33962825</pmid><doi>10.1016/j.pec.2021.04.027</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0001-5225-6639</orcidid></addata></record> |
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subjects | Activities of Daily Living Aged Breast cancer screening Decision Making Early Detection of Cancer Humans Informed decision-making Male Mass Screening Older adults Overdiagnosis Prostate cancer screening Prostatic Neoplasms - diagnosis |
title | Psychosocial and clinical predictors of continued cancer screening in older adults |
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