UBC Faculty Research and Publications

Ending cervical cancer screening: attitudes and beliefs from ethnically diverse older women Sawaya, G.; Iwaoka-Scott, A. Y.; Kim, S.; Wong, Sabrina T.; Huang, A. J.; Washington, A. E.; Perez-Stable, E. J.

Abstract

BACKGROUND Guidelines support ending cervical cancer screening in women aged 65 or 70 years and older with prior normal testing, but little is known about women’s attitudes and beliefs about ending screening. METHODS We recruited and interviewed 199 women aged 65 years and older from primary care clinics. All had prior cervical cancer screening and no prior hysterectomy. In face-to-face interviews conducted in English, Spanish, Cantonese or Mandarin, women were asked about various aspects of cervical cancer screening and their plans to continue lifelong screening. RESULTS Most interviewees (74.4%) were non-White (44.7% Asian, 18.1% Latina and 11.6% African-American). Most (68%) thought that lifelong screening was either important or very important, a belief held more strongly by African-American (77%) and Latina (83%) women compared to women in other ethnic groups (p<0.01); most (77%) had no plans to discontinue screening or had ever thought of discontinuing (69%). When asked if they would end screening if recommended by their physician, however, 68% responded “yes.” In multivariable analyses, older age (OR=1.25 per year; CI=1.09-1.44), having public insurance (OR=3.84; CI=1.56-9.46) and having no personal (OR=3.13; CI=1.12-8.73) or family (OR=3.06; CI=1.19-7.89) history of cancer remained independent predictors of ending screening if recommended by their physician. CONCLUSIONS The majority of these ethnically diverse women believe that lifelong cervical cancer screening is important. Many women, however, reported they would end screening if recommended by their physician, underscoring the important role of clinicians in informing women about screening guidelines designed to maximize screening benefits and minimize harms.

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Attribution-NonCommercial-NoDerivatives 4.0 International