Development and Evaluation of Messages for Reducing Overscreening of Breast Cancer in Older Women

Nancy L. Schoenborn, Sarah E. Gollust, Mara A. Schonberg, Craig E. Pollack, Cynthia M. Boyd, Qian Li Xue, Rebekah H. Nagler

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Many older women are screened for breast cancer beyond guideline-recommended thresholds. One contributor is pro-screening messaging from health care professionals, media, and family/friends. In this project, we developed and evaluated messages for reducing overscreening in older women. Methods: We surveyed women ages 65+ who were members of a nationally representative online panel. We constructed 8 messages describing reasons to consider stopping mammograms, including guideline recommendations, false positives, overdiagnosis, and diminishing benefits from screening due to competing risks. Messages varied in their format; some presented statistical evidence, and some described short anecdotes. Each participant was randomized to read 4 of 8 messages. We also randomized participants to one of 3 message sources (clinician, family member, and news story). We assessed whether the message would make participants "want to find out more information" and "think carefully" about mammograms. Results: Participants (N=790) had a mean age of 73.5 years; 25.8% were non-White. Across all messages, 73.0% of the time, participants agreed that the messages would make them seek more information (range among different messages=64.2%-78.2%); 46.5% of the time participants agreed that the messages would make them think carefully about getting mammograms (range =36.7%-50.7%). Top-rated messages mentioned false-positive anecdotes and overdiagnosis evidence. Ratings were similar for messages from clinicians and news sources, but lower from the family member source. Conclusions: Overall, participants positively evaluated messages designed to reduce breast cancer overscreening regarding perceived effects on information seeking and deliberation. Combining the top-rated messages into messaging interventions may be a novel approach to reduce overscreening.

Original languageEnglish (US)
Pages (from-to)296-304
Number of pages9
JournalMedical care
Volume62
Issue number5
DOIs
StatePublished - May 1 2024

Keywords

  • breast cancer
  • cancer screening
  • communication
  • geriatrics

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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