Shared Decision-Making and Women's Adherence to Breast and Cervical Cancer Screenings.

Jayoung Han,Paiboon Jungsuwadee,Dongwoo Ko,Olufunmilola Abraham

doi:10.3390/ijerph15071509

Abstract

We examined the effect of shared decision-making (SDM) on women’s adherence to breast and cervical cancer screenings and estimated the prevalence and adherence rate of screenings. The study used a descriptive cross-sectional design using the 2017 Health Information National Trends Survey (HINTS) data collected by the National Cancer Institute. Adherence was defined based on the guidelines from the American Cancer Society and the composite measure of shared decision-making was constructed using three items in the data. Multivariable logistic regression was performed to examine the association between the SDM and adherence, controlling for cancer beliefs and socio-demographic variables. The analysis included 742 responses. Weighted to represent the U.S. population, 68.1% adhered to both breast and cervical cancer screening guidelines. The composite measure of SDM was reliable (α = 0.85), and a higher SDM score was associated with women’s screening adherence (b = 0.17; p = 0.009). There were still women who did not receive cancer screenings as recommended. The results suggest that the use of the SDM approach for healthcare professionals’ communication with patients can improve screening adherence.

Highlights

Breast cancer is the most diagnosed cancer among women, while cervical cancer is the leading cause of cancer deaths in women aged 20–39 in the United States [1]
The study used the data from 2017 Health Information National Trends Survey (HINTS) 5 cycle 1 collected by the National Cancer Institute (NCI)
We found a positive association between the shared decision-making (SDM) approach and women’s adherence to breast and cervical cancer screening guidelines, after controlling for cancer beliefs and socio-demographic characteristics

Summary

Introduction

Breast cancer is the most diagnosed cancer among women, while cervical cancer is the leading cause of cancer deaths in women aged 20–39 in the United States [1]. The American Cancer Society (ACS) estimates that in 2018, 266,120 and 13,240 American women will be newly diagnosed with breast and cervical cancers, respectively [1]. The ACS estimates that 40,920 and 4170 women will die of breast cancer and cervical cancer, respectively, in 2018 [1]. The probability of developing invasive breast cancer increases with age, while the probability of developing cervical cancer peaks at age 50 and younger [2]. Between 1990 and 2015, the age-adjusted mortality rate of breast cancer decreased by 39%, possibly because of a combination of early detection and advances in treatment of breast cancer [3]. The reduction in cervical cancer is potentially influenced by the widespread use of the Papanicolaou (Pap) test, which has been demonstrated to have a strong association with the incidence of advanced stage cervical cancer and in

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