{"doi":"10.1101/2025.01.30.25321380","title":"Understanding motivations of older women to continue or discontinue breast cancer screening","abstract":"Background: Breast cancer screening guidelines indicate screening in women over 75 years of age is optional, depending upon patient health and preferences. Objectives: To link experiences and perceptions of older women concerning screening to their intention to continue or discontinue screening. Design: Qualitative comparative study, comparing continuers and discontinuers. Setting: Community-residing adults. Participants: A purposive sample (n=59) with equal representation of White, Black, and Hispanic women by age (70-74 years and 75 and older) and educational level (≤12 grade and >12 grade). Measurements: In-depth qualitative interviews explored women's perceptions of mammograms, the benefits and risks of screening, and personal screening experiences. Interviews were coded and quality-checked by two or more coders. A qualitative comparative analysis (QCA) was used to identify combinations of personal characteristics and themes linked to the intention to continue (n=32) or discontinue (n=27) screening. Results: Personal experience themes were strongly linked to the intention to continue or discontinue. Women who mentioned recent screening (within three years) and either a spontaneously mentioned cancer story concerning a friend or family member or a doctor's screening recommendation intended to continue screening (91% true positive rate, model sensitivity). Women who did not schedule screening and who did not mention a cancer story or a doctor's recommendation (or neither) intended to discontinue screening (81% true negative rate, model specificity). These themes transcended differences in race/ethnicity, age, and educational level. Conclusion: Continuation of breast cancer screening in older women is motivated by their personal screening history combined with cancer experiences and/or a doctor's screening recommendation.","journal":"medRxiv","year":2025,"id":561412,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9469,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":528453,"name":"Monique R. Pappadis","orcid":"0000-0003-4742-4380","position":1,"is_corresponding":false},{"id":692725,"name":"Shilpa Krishnan","orcid":"0000-0002-9419-0495","position":2,"is_corresponding":false},{"id":1463825,"name":"Marsja R. Stearnes","orcid":null,"position":3,"is_corresponding":false},{"id":1463509,"name":"Kristin M. Sheffield","orcid":"0000-0003-3940-1795","position":4,"is_corresponding":false},{"id":535541,"name":"Alai Tan","orcid":"0000-0002-2907-9088","position":5,"is_corresponding":false},{"id":1463510,"name":"Jeffrey Z. Qi","orcid":"0009-0007-0789-4982","position":6,"is_corresponding":false},{"id":347554,"name":"James S. Goodwin","orcid":"0000-0001-5507-1613","position":7,"is_corresponding":false},{"id":769080,"name":"Susan C. Weller","orcid":"0000-0002-0695-736X","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":null,"created_at":"2026-07-19T02:55:58.259104Z","pmid":"39974035","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}