Abstract
Background: the rise in life expectancy, together with age-related increase in the incidence of most cancers, has led to mounting interest in cancer screening in older people. In England, routine invitations stop and an ‘opt-in’ (individual request) process is available from ages 71 to 76 years for breast and colorectal screening respectively. Little is known about public attitudes towards age-stoppage policy.Objective: this study examined public attitudes to current stoppage policy, information preferences and intentions to request screening beyond the age of routine invitations.Sample: participants (n = 927; age 60–74 years) were recruited as part of a TNS Research International survey and took part in home-based, computer-assisted interviews.Methods: measures included: (i) attitudes towards current stoppage policy, (ii) preference for communications about screening after the end of the routine invitation period and (iii) intention to opt-in.Results: the majority of respondents (78%) did not agree with age-based stoppage policies. Most (83%) wanted a strong recommendation to opt-in after this age, although the number who thought they would follow such a recommendation was much lower (27%). A majority of participants (54%) thought information on screening at older ages should come from their general practitioner (GP).Conclusion: this survey indicates that older people in England wish to continue to be actively invited for cancer screening, although only a minority think that they would ultimately take up the offer. Primary care may play a role in negotiating a shared decision that is based on individual circumstances.
Highlights
The incidence of most cancers increases with age [1, 2]
Objective: this study examined public attitudes to current stoppage policy, information preferences and intentions to request screening beyond the age of routine invitations
Conclusion: this survey indicates that older people in England wish to continue to be actively invited for cancer screening, only a minority think that they would take up the offer
Summary
The incidence of most cancers increases with age [1, 2]. More than three in five (63%) cancers in the UK are diagnosed in people aged 65 and over, and more than a third (36%) are diagnosed in people over 75 years. Rapid increases in life expectancy [3, 4] have focused attention on cancer screening procedures and practices among older people [5,6,7,8]. In the UK, organised screening programmes are run by the National Health Service (NHS), with call–recall programmes in place for breast, cervical and colorectal (CRC) cancer. In England, routine cervical screening invitations continue to age 64 years, breast screening to 70 and CRC screening to age 75 [9]. Most international screening guidelines have similar age-based recommendations [10,11,12]
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