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Plans to Stop Cancer Screening Tests Among Adults Who Recently Considered Screening

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Abstract

Objective

We sought to estimate what proportion of adults plan to stop cancer screening tests among adults who recently considered screening and to explore factors associated with these screening plans.

Design

Telephone Survey

Participants

A total of 1,237 participants aged 50 and older who reported having made one or more cancer screening decisions in the past 2 years completed 1,454 cancer screening modules for breast, prostate and colorectal screening.

Main Results

Of all module respondents, 9.8% reported plans to stop screening, 12.6% for breast, 6.0 % for prostate and 9.5% for colon cancer. We found no statistically significant differences in plans to stop for those ages ≥70 (8.2%) compared to those ages 50 to 69 (10.2%) (p = 0.14.) Black respondents were less likely to report plans to stop than white respondents (OR = 0.32, 95% CI 0.12, 0.87). Participation in the decision-making process was associated with plans to stop screening; those who reported they made the final decision about screening (OR 5.9, 95% CI 1.4, 24.7) or made the decision with the health care provider (OR 4.1, 95% CI 1.0, 16.8) were more likely to have plans to stop screening compared to respondents who reported that their health care provider made the final decision.

Conclusions

Plans to stop screening were uncommon among participants who had recently faced a screening decision. Given the recent US Preventive Services Task Force recommendations limiting routine cancer screening for older adults, additional efforts to educate adults about the potential risks and benefits of screening may be warranted.

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Acknowledgements

The DECISIONS study was supported by the Foundation for Informed Medical Decision Making. Dr. Lewis was supported by a K07 Mentored Career Development Award (5K07CA104128) from the National Cancer Institute. Dr. Zikmund-Fisher was supported by a Mentored Research Scholar Grant from the American Cancer Society (MRSG-06-130-01-CPPB).

Potential Financial Conflicts of Interest

The Foundation for Informed Medical Decision Making (FIMDM) provided the funding for this research. While the research involved substantial collaboration among Dr. Lewis, the University of Michigan (UM) research team and FIMDM representatives, the research grant was awarded in compliance with UM’s policies, which bar funder interference in scholarly work. Design of the survey and control of the research data rested with the UM investigator team, and Dr. Lewis had final authority regarding the content of the paper. During this research, Dr. Levin was Director of Research at FIMDM. She provided input on the research design, feedback on analyses and constructive comments on manuscript drafts consistent with her listed co-authorship role.

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Authors and Affiliations

  1. Division of General Internal Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill, NC, 27599, USA

    Carmen L. Lewis MD, MPH & Michael P. Pignone MD, MPH

  2. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd, CB# 7590, Chapel Hill, NC, 27599, USA

    Carmen L. Lewis MD, MPH & Michael P. Pignone MD, MPH

  3. Institute for Social Research, University of Michigan, Ann Arbor, MI, 48106, USA

    Mick P. Couper PhD

  4. Foundation for Informed Medical Decision Making, Boston, MA, 02108, USA

    Carrie A. Levin PhD

  5. HSR&D Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, MI, 48105, USA

    Brian J. Zikmund-Fisher PhD

  6. Division of General Internal Medicine, University of Michigan, Ann Arbor, MI, 48109, USA

    Brian J. Zikmund-Fisher PhD

Authors
  1. Carmen L. Lewis MD, MPH
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  2. Mick P. Couper PhD
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  3. Carrie A. Levin PhD
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  4. Michael P. Pignone MD, MPH
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  5. Brian J. Zikmund-Fisher PhD
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Corresponding author

Correspondence to Carmen L. Lewis MD, MPH.

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Lewis, C.L., Couper, M.P., Levin, C.A. et al. Plans to Stop Cancer Screening Tests Among Adults Who Recently Considered Screening. J GEN INTERN MED 25, 859–864 (2010). https://doi.org/10.1007/s11606-010-1346-5

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  • DOI: https://doi.org/10.1007/s11606-010-1346-5

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