AS216 - Decision-making about cancer screening among older women

[This page is intended to provide a study summary, the sections of which are below. Please complete these sections, as applicable. The headings below are suggested headings. You can remove inapplicable sections, or add new ones relevant to your study]

Investigator Names and Contact Information

Catherine R. Messina PhD [ cmessina@notes.cc.sunysb.edu ]

Abstract

Currently, not much is known about how older adults make cancer screening decisions. Screening guidelines based on studies involving younger samples may not apply to older adults. Risks for adverse screening-related events also increase with age.  Thus, understanding how older adults make cancer screening decisions gains importance as the population ages. The purpose of this proposed WHI ancillary study is to investigate, using the WHI OS cohort participating at the Stony Brook Clinical Center, decision-making processes employed older women aged 60 years and older for colorectal, cervical, and breast cancer screening.  These three cancers were selected for examination because older women make decisions about  whether or not to have such screening. 1765 Stony Brook OS women will be recruited to participate and a prospective study design will be employed over a 5-year study period. Decision making about treatment will also be examined in the small subgroup of women who develop cancers.  Study findings will be utilized to inform the design of subsequent intervention projects focused on enhancing decision-making and satisfaction with about cancer screening among other samples of older women and their primary care physicians.

Specific Aims

The primary goal of this ancillary study will be to investigate, prospectively, decision-making processes utilized by women age 60 years and older, regarding their use of colorectal, cervical, and breast cancer screening exams. 

Primary specific aims will be to:

1.  Investigate decision-making processes employed by women aged 60 years and older for colorectal, cervical, and breast cancer screening, using the WHI OS cohort participating at the Stony Brook Clinical Center.  This investigation will examine aspects of decision-making which include older women's decision-making preferences, actual level of involvement in decision-making between the patient and her physician, decisional conflict, satisfaction with the decision, patient/physician communication, and the influence of these on their use of colorectal, cervical, and breast cancer screening. 

2. Examine the influence of factors such as sources of knowledge about colorectal, cervical, and breast cancer, social support, competing priorities, demographic characteristics, and health behaviors on screening decisions and use of screening tests.

Secondary specific aims will be to:

1.  Track the follow-up of positive tests and the impact of decision-making on likelihood of obtaining a follow-up exam

2. Identify women who develop colorectal, cervical, or breast cancer and experience other cancers over the study period and further explore decision-making about treatment for cancers in this subgroup.