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Pilot Evaluation of Patient-centered Survey Tools for Breast Cancer Screening Decision-making in Women 75 and Older

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Objective: Breast cancer screening recommendations in women ≥75 years of age vary. Studies show harm with over-screening, and limited benefit in mammography for women with short life expectancy; however, many women ≥75 years continue screening. We pilot-tested a validated decision-aid in women ≥75 years to evaluate feasibility of implementation in an internal medicine clinic with secondary objectives to determine if it improved knowledge about mammogram screening recommendations and/or changed intent to screen. Methods: Eligible women were mailed a pre-intervention survey assessing their knowledge of breast cancer and screening. At a routine appointment they were given a decision-aid on yearly screening after age 75. Following this appointment they completed a post-intervention survey. Results: Overall, 28% (N = 16) of eligible participants enrolled, with 8 completing the study. Pre-intervention, all participants planned to get a screening mammogram in the next year; post-intervention, 63% planned to continue screening. Conclusions: Women ≥75 years of age may consider changing their screening schedule based on a decision-aid given at a well-visit appointment. Challenges included a small sample size and need for better recruitment techniques in this population.
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Keywords: BREAST CANCER OVER-SCREENING; BREAST CANCER SCREENING; HEALTHCARE DECISION-AID; HEALTHCARE DECISION-MAKING; HEALTHCARE FOR OLDER WOMEN

Document Type: Research Article

Publication date: January 1, 2020

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  • Health Behavior and Policy Review is a rigorously peer-reviewed scholarly bi-monthly publication that seeks manuscripts on health behavior or policy topics that represent original research, including papers that examine the development, advocacy, implementation, or evaluation of policies around specific health issues. The Review especially welcomes papers that tie together health behavior and policy recommendations. Articles are available through subscription or can be ordered individually from the Health Behavior and Policy Review site.
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