Abstract
Introduction: Breast cancer is the most commonly diagnosed cancer in women in the United States. Breast cancer screening mammography helps detect cancer earlier, improving treatment success. Similar to other screening exams, making the decision to get screened for breast cancer involves evaluating the risks and benefits of the procedure which can vary by age. While the assessment for breast cancer screening is often personal, few screening decision aids have been created with ethically and racially diverse women for use in a variety of settings, including low-resource settings. We aim to characterize the primary influences among African American women when making a decision about breast cancer screening mammography and how these influences may differ based on age in order to better engage this demographic to inform decision aid development. Methods: Focus groups were performed to elicit the views and opinions of African American women ages 40 to 75 on the topic of breast cancer screenings. Using the Andersen Behavioral Model of Health Services Use, a qualitative analysis of the focus groups transcripts was performed using a deductive coding approach. The Andersen Model included predisposing factors (e.g. age, knowledge, beliefs, fears and fatalism), enabling factors (e.g. health insurance and health utilization), and need factors (e.g. physician recommendation and family/personal history). Sociodemographic information was collected, and quantitative data were summarized using descriptive statistics.
Results: This study included 51 African American women ages 40 -75 (ages 40-49 n=23, ages 50-75 n=28). In the 40-49 age cohort, 82.3% (n=19) has had at least one mammography and 69.6% (n=16) had high health literacy. In the 50-75 age cohort, 100% of women had at least one mammography and 71.4% (n=20) had high health literacy. For all of the women in the study, the major influences for breast cancer screening include physician recommendation, family/personal medical history as well as health utilization (e.g. wanting to be proactive about their health).
Participants indicated that topic of autonomy was also important as they prioritized caring for themselves and making a personal decision. However, for women ages 50- 75, customer service was also a major influence for breast cancer screening (e.g. how they were treated while accessing medical services for breast cancer screening).
Conclusions: The primary influences for breast cancer screening among African American women age 40-75 can vary with age. A better understanding of these influences can help inform decision aids to meet the needs of ethnically and racially diverse women across various ages eligible for breast cancer screening mammography.
Citation Format: Kamilah S. Abdur-Rashid, Ashley J. Housten, Graham A. Colditz. Perceived barriers and facilitators for breast cancer screening influences among African American women ages 40-75 [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-265.
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