Communicating About Stopping Cancer Screening: Comparing Clinicians' and Older Adults' Perspectives

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND OBJECTIVES: Older adults with limited life expectancy frequently receive cancer screening. We sought to compare the perspectives of clinicians and older adults on how to communicate about stopping cancer screening. RESEARCH DESIGN AND METHODS: We used data from two studies involving semistructured in-person individual interviews, in which we asked about perspectives on communication about stopping cancer screening, with 28 primary care clinicians and 40 community-dwelling older adults, respectively. RESULTS: We identified three major themes: (a) Consensus among primary care clinicians and older adults regarding communication around stopping cancer screening. Both groups considered discussing the benefits/risks of cancer screening and involving patients in the decision as important and mentioned framing screening cessation as shift in health priorities. (b) Differences in perceived reactions to stopping cancer screening. Primary care clinicians were concerned about patient reaction to stopping cancer screening, whereas older adults reported no negative reactions in the context of a trusting relationship. (c) Differences in views around whether to discuss life expectancy in the context of stopping cancer screening. Clinicians rarely discussed life expectancy in this context, whereas older adults were divided on whether life expectancy should be discussed. DISCUSSION AND IMPLICATIONS: Given the heterogeneity in older adults' preferences, it is important to assess whether patients want to discuss life expectancy when discussing stopping cancer screening, though use of the specific term "life expectancy" may not be necessary. Instead, focusing discussion on the benefits/risks of cancer screening and mentioning shift in health priorities are acceptable communication strategies for both clinicians and older adults.

Original languageEnglish (US)
Pages (from-to)S67-S76
JournalThe Gerontologist
Volume59
Issue number1
DOIs
StatePublished - May 17 2019

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Early Detection of Cancer
Life Expectancy
Health Priorities
Primary Health Care
Communication
Independent Living
Consensus
Research Design
Interviews

Keywords

  • Longevity
  • Physician-patient communication
  • Preventive medicine
  • Qualitative research methods

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology

Cite this

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title = "Communicating About Stopping Cancer Screening: Comparing Clinicians' and Older Adults' Perspectives",
abstract = "BACKGROUND AND OBJECTIVES: Older adults with limited life expectancy frequently receive cancer screening. We sought to compare the perspectives of clinicians and older adults on how to communicate about stopping cancer screening. RESEARCH DESIGN AND METHODS: We used data from two studies involving semistructured in-person individual interviews, in which we asked about perspectives on communication about stopping cancer screening, with 28 primary care clinicians and 40 community-dwelling older adults, respectively. RESULTS: We identified three major themes: (a) Consensus among primary care clinicians and older adults regarding communication around stopping cancer screening. Both groups considered discussing the benefits/risks of cancer screening and involving patients in the decision as important and mentioned framing screening cessation as shift in health priorities. (b) Differences in perceived reactions to stopping cancer screening. Primary care clinicians were concerned about patient reaction to stopping cancer screening, whereas older adults reported no negative reactions in the context of a trusting relationship. (c) Differences in views around whether to discuss life expectancy in the context of stopping cancer screening. Clinicians rarely discussed life expectancy in this context, whereas older adults were divided on whether life expectancy should be discussed. DISCUSSION AND IMPLICATIONS: Given the heterogeneity in older adults' preferences, it is important to assess whether patients want to discuss life expectancy when discussing stopping cancer screening, though use of the specific term {"}life expectancy{"} may not be necessary. Instead, focusing discussion on the benefits/risks of cancer screening and mentioning shift in health priorities are acceptable communication strategies for both clinicians and older adults.",
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