{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:22:21Z","timestamp":1768569741199,"version":"3.49.0"},"posted":{"date-parts":[[2025,2,3]]},"group-title":"Geriatric Medicine","reference-count":55,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,2,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Breast cancer screening guidelines indicate screening in women over 75 years of age is optional, depending upon patient health and preferences.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To link experiences and perceptions of older women concerning screening to their intention to continue or discontinue screening.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Qualitative comparative study, comparing continuers and discontinuers.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Community-residing adults.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>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 (\u226412 grade and &gt;12 grade).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Measurements<\/jats:title>\n                  <jats:p>In-depth qualitative interviews explored women\u2019s 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.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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\u2019s 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\u2019s recommendation (or neither) intended to discontinue screening (81% true negative rate, model specificity). These themes transcended differences in race\/ethnicity, age, and educational level.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Continuation of breast cancer screening in older women is motivated by their personal screening history combined with cancer experiences and\/or a doctor\u2019s screening recommendation.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.01.30.25321380","type":"posted-content","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T20:05:31Z","timestamp":1738613131000},"source":"Crossref","is-referenced-by-count":0,"title":["Understanding motivations of older women to continue or discontinue breast cancer screening"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0695-736X","authenticated-orcid":false,"given":"Susan C.","family":"Weller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique R.","family":"Pappadis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shilpa","family":"Krishnan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marsja R.","family":"Stearnes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin M.","family":"Sheffield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alai","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey Z.","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James S.","family":"Goodwin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025020503100492000_2025.01.30.25321380v1.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.5534"},{"key":"2025020503100492000_2025.01.30.25321380v1.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12783"},{"key":"2025020503100492000_2025.01.30.25321380v1.3","unstructured":"American Cancer Society. American Cancer Society Recommendations for the Early Detection of Breast Cancer. https:\/\/www.cancer.org\/cancer\/types\/breast-cancer\/screening-tests-and-early-detection\/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html."},{"key":"2025020503100492000_2025.01.30.25321380v1.4","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002158"},{"key":"2025020503100492000_2025.01.30.25321380v1.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600249"},{"key":"2025020503100492000_2025.01.30.25321380v1.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2021.11.013"},{"key":"2025020503100492000_2025.01.30.25321380v1.7","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000115"},{"key":"2025020503100492000_2025.01.30.25321380v1.8","unstructured":"Social Security. Period Life Table, 2021, as used in the 2024 Trustees Report. https:\/\/www.ssa.gov\/oact\/STATS\/table4c6.html"},{"key":"2025020503100492000_2025.01.30.25321380v1.9","unstructured":"National Center for Health Statistics. Table 33. Use of mammography among women aged 40 and over. Hyattsville, MD. Health, United States, 2018. 2018;"},{"key":"2025020503100492000_2025.01.30.25321380v1.10","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12123"},{"key":"2025020503100492000_2025.01.30.25321380v1.11","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.72.1209"},{"key":"2025020503100492000_2025.01.30.25321380v1.12","unstructured":"Surveillance Epidemiology and End Results Program. Breast: SEER incidence rates by age at diagnosis, 2016-2020, by sex, delay-adjusted SEER incidence rate, allraces\/ethnicities. National Cancer Institute. Accessed Sept 5, 2024, https:\/\/seer.cancer.gov\/statistics-network\/explorer\/application.html?site=55&data_type=1&graph_type=3&compareBy=sex&chk_sex_3=3&rate_type=2&race=1&advopt_precision=1&advopt_show_ci=on&hdn_view=0#resultsRegion0."},{"key":"2025020503100492000_2025.01.30.25321380v1.13","unstructured":"Surveillance Epidemiology and End Results Program. Breast: US mortality rates by age at death, 2016-2020, by sex, all races\/ethnicities. National Cancer Institute. Accessed Sept 5, 2024, https:\/\/seer.cancer.gov\/statistics-network\/explorer\/application.html?site=55&data_type=2&graph_type=3&compareBy=sex&chk_sex_3=3&race=1&advopt_precision=1&advopt_show_ci=on&hdn_view=0#resultsRegion0."},{"key":"2025020503100492000_2025.01.30.25321380v1.14","doi-asserted-by":"crossref","unstructured":"Nelson HD , Cantor A , Humphrey L , et al. Screening for Breast Cancer: A Systematic Review to Update the 2009 U.S. Preventive Services Task Force Recommendation. Evidence Syntheses No 124. Rockville (MD): Agency for Healthcare Research and Quality; 2016.","DOI":"10.7326\/M15-0970"},{"key":"2025020503100492000_2025.01.30.25321380v1.15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1109283"},{"key":"2025020503100492000_2025.01.30.25321380v1.16","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20512"},{"key":"2025020503100492000_2025.01.30.25321380v1.17","doi-asserted-by":"publisher","DOI":"10.17061\/phrp2731728"},{"key":"2025020503100492000_2025.01.30.25321380v1.18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.1398"},{"key":"2025020503100492000_2025.01.30.25321380v1.19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.2834"},{"key":"2025020503100492000_2025.01.30.25321380v1.20","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5041"},{"key":"2025020503100492000_2025.01.30.25321380v1.21","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.2247"},{"key":"2025020503100492000_2025.01.30.25321380v1.22","doi-asserted-by":"publisher","DOI":"10.1007\/BF02743148"},{"key":"2025020503100492000_2025.01.30.25321380v1.23","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.2903"},{"key":"2025020503100492000_2025.01.30.25321380v1.24","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4708"},{"key":"2025020503100492000_2025.01.30.25321380v1.25","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4758"},{"key":"2025020503100492000_2025.01.30.25321380v1.26","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-7-26"},{"key":"2025020503100492000_2025.01.30.25321380v1.27","doi-asserted-by":"publisher","DOI":"10.1097\/01.cej.0000391564.03265.3f"},{"key":"2025020503100492000_2025.01.30.25321380v1.28","doi-asserted-by":"publisher","DOI":"10.2307\/2095572"},{"key":"2025020503100492000_2025.01.30.25321380v1.29","doi-asserted-by":"crossref","unstructured":"Rihoux B , De Meur G. Chapter 3: Crisp-Set Qualitative Comparative Analysis (csQCA). In: Rihoux B , Ragin CC , eds. Configurational Comparative Methods: Qualitative Comparative Analysis (QCA) and Related Techniques. Sage Publications; 2009:33\u201368.","DOI":"10.4135\/9781452226569.n3"},{"key":"2025020503100492000_2025.01.30.25321380v1.30","doi-asserted-by":"publisher","DOI":"10.1177\/1065912909338464"},{"key":"2025020503100492000_2025.01.30.25321380v1.31","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022138"},{"key":"2025020503100492000_2025.01.30.25321380v1.32","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2018.1431026"},{"key":"2025020503100492000_2025.01.30.25321380v1.33","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.18.2083"},{"key":"2025020503100492000_2025.01.30.25321380v1.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2016.07.034"},{"key":"2025020503100492000_2025.01.30.25321380v1.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2020.05.002"},{"key":"2025020503100492000_2025.01.30.25321380v1.36","unstructured":"Johnson JC. Selecting ethnographic informants. Qualitative research methods. Sage Publications; 1990:96 p."},{"key":"2025020503100492000_2025.01.30.25321380v1.37","doi-asserted-by":"publisher","DOI":"10.1080\/13645579.2015.1005453"},{"key":"2025020503100492000_2025.01.30.25321380v1.38","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198606"},{"key":"2025020503100492000_2025.01.30.25321380v1.39","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X02239569"},{"key":"2025020503100492000_2025.01.30.25321380v1.40","unstructured":"QSR International Pty Ltd. NVivo 10 Qualitative Data Analysis Software. Version 10. QSR International Pty Ltd; 2012."},{"key":"2025020503100492000_2025.01.30.25321380v1.41","unstructured":"Bernard HR , Ryan GW . Analyzing Qualitative Data: Systematic Approaches. SAGE Publications; 2009"},{"key":"2025020503100492000_2025.01.30.25321380v1.42","doi-asserted-by":"crossref","unstructured":"Weller SC , Romney AK . Systematic Data Collection, Qualitative Research Methods. vol 10. Sage Publications; 1988.","DOI":"10.4135\/9781412986069"},{"key":"2025020503100492000_2025.01.30.25321380v1.43","unstructured":"SPSS Inc. SPSS. Chicago: SPSS Inc.; 1990."},{"key":"2025020503100492000_2025.01.30.25321380v1.44","unstructured":"Cronqvist L. Tosmana. Version 1.521. University of Trier, Germany; 2016. http:\/\/www.tosmana.net"},{"key":"2025020503100492000_2025.01.30.25321380v1.45","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-024-02539-8"},{"key":"2025020503100492000_2025.01.30.25321380v1.46","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-024-03094-z"},{"key":"2025020503100492000_2025.01.30.25321380v1.47","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.28700"},{"key":"2025020503100492000_2025.01.30.25321380v1.48","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-024-08656-3"},{"key":"2025020503100492000_2025.01.30.25321380v1.49","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420180062008"},{"key":"2025020503100492000_2025.01.30.25321380v1.50","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1998.tb02746.x"},{"key":"2025020503100492000_2025.01.30.25321380v1.51","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.80.4.446"},{"key":"2025020503100492000_2025.01.30.25321380v1.52","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2003.01.001"},{"key":"2025020503100492000_2025.01.30.25321380v1.53","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605662"},{"key":"2025020503100492000_2025.01.30.25321380v1.54","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X10378701"},{"key":"2025020503100492000_2025.01.30.25321380v1.55","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X03257690"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.01.30.25321380","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:26:52Z","timestamp":1768508812000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2025.01.30.25321380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,3]]},"references-count":55,"URL":"https:\/\/doi.org\/10.1101\/2025.01.30.25321380","relation":{"is-preprint-of":[{"id-type":"doi","id":"10.1371\/journal.pone.0319141","asserted-by":"subject"}]},"subject":[],"published":{"date-parts":[[2025,2,3]]},"subtype":"preprint"}}