Older Women Fear They Can't Beat Breast Cancer

Older women who fear the possibility of becoming ill still forgo recommended routine breast cancer screening unless they feel that they could successfully overcome health problems, according to the findings of a new Canadian study.

Interviews with 198 women, age 50 to 75, were designed to assess which factors predicted adherence to guidelines calling for women to undergo mammography every other year.

Overall, more than half of the women went for routine screening. Women age 50 to 69 years were more likely to adhere to the screening guidelines than women age 70 to 75 years (58 percent versus 43 percent).

Despite an increasing incidence of breast cancer and the benefits of regular mammography, "adherence to mammography screening guidelines is one behavior that is poorly practiced, especially among older women," the study said. That trend was reflected in the finding that women over the age of 70 were most likely to report that there was "no need" for them to get screened.

Margaret E. A. Black, PhD, an associate professor in the School of Nursing at McMasters University in Ontario, Canada, and her colleagues found that women who could envision the consequences of becoming ill were significantly more likely to get screened for breast cancer regularly if they believed they could battle health problems. Women who were not concerned about breast cancer but perceived that mammography would benefit their health also were more likely to get screened than women who were worried but thought mammography wouldn’t make a difference.

The study is published in the April Issue of Health Education & Behavior.

The study also showed that women who had clinical breast examinations were much more likely to go for regular mammography screening. Having their physician recommend screening also predicted adherence to screening guidelines.

However, women who had a history of noncancer breast problems, such pain, swelling, a benign lump or abnormal mammogram were no more likely to adhere to the screening guidelines than other women. Women with family histories of breast cancer also were no more likely than those without a family history to get screened every two years.

"Although other studies have found that breast problem history has strongly predicted adherence, researchers have suggested physician reinforcement may have moderated this effect," the investigators said. "Nevertheless, the present findings support the notion that objective risk is insufficient to promote behavior and suggests that this risk needs to be personally relevant."

The study was conducted as a cross-sectional survey of women recruited from community and women’s groups. Women with a history of breast cancer were excluded from the study. During the survey, women were asked about feared and hoped-for health outcomes. The women were also asked whether they felt capable of preventing or avoiding feared outcomes and accomplishing hoped-for outcomes.