Journal of General Internal Medicine

, Volume 25, Issue 8, pp 859–864 | Cite as

Plans to Stop Cancer Screening Tests Among Adults Who Recently Considered Screening

  • Carmen L. LewisEmail author
  • Mick P. Couper
  • Carrie A. Levin
  • Michael P. Pignone
  • Brian J. Zikmund-Fisher
Original Research



We sought to estimate what proportion of adults plan to stop cancer screening tests among adults who recently considered screening and to explore factors associated with these screening plans.


Telephone Survey


A total of 1,237 participants aged 50 and older who reported having made one or more cancer screening decisions in the past 2 years completed 1,454 cancer screening modules for breast, prostate and colorectal screening.

Main Results

Of all module respondents, 9.8% reported plans to stop screening, 12.6% for breast, 6.0 % for prostate and 9.5% for colon cancer. We found no statistically significant differences in plans to stop for those ages ≥70 (8.2%) compared to those ages 50 to 69 (10.2%) (p = 0.14.) Black respondents were less likely to report plans to stop than white respondents (OR = 0.32, 95% CI 0.12, 0.87). Participation in the decision-making process was associated with plans to stop screening; those who reported they made the final decision about screening (OR 5.9, 95% CI 1.4, 24.7) or made the decision with the health care provider (OR 4.1, 95% CI 1.0, 16.8) were more likely to have plans to stop screening compared to respondents who reported that their health care provider made the final decision.


Plans to stop screening were uncommon among participants who had recently faced a screening decision. Given the recent US Preventive Services Task Force recommendations limiting routine cancer screening for older adults, additional efforts to educate adults about the potential risks and benefits of screening may be warranted.


cancer screening decision making aged 



The DECISIONS study was supported by the Foundation for Informed Medical Decision Making. Dr. Lewis was supported by a K07 Mentored Career Development Award (5K07CA104128) from the National Cancer Institute. Dr. Zikmund-Fisher was supported by a Mentored Research Scholar Grant from the American Cancer Society (MRSG-06-130-01-CPPB).

Potential Financial Conflicts of Interest

The Foundation for Informed Medical Decision Making (FIMDM) provided the funding for this research. While the research involved substantial collaboration among Dr. Lewis, the University of Michigan (UM) research team and FIMDM representatives, the research grant was awarded in compliance with UM’s policies, which bar funder interference in scholarly work. Design of the survey and control of the research data rested with the UM investigator team, and Dr. Lewis had final authority regarding the content of the paper. During this research, Dr. Levin was Director of Research at FIMDM. She provided input on the research design, feedback on analyses and constructive comments on manuscript drafts consistent with her listed co-authorship role.


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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Carmen L. Lewis
    • 1
    • 2
    Email author
  • Mick P. Couper
    • 3
  • Carrie A. Levin
    • 4
  • Michael P. Pignone
    • 1
    • 2
  • Brian J. Zikmund-Fisher
    • 5
    • 6
  1. 1.Division of General Internal Medicine and Clinical EpidemiologyUniversity of North CarolinaChapel HillUSA
  2. 2.Cecil G. Sheps Center for Health Services ResearchUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Institute for Social ResearchUniversity of MichiganAnn ArborUSA
  4. 4.Foundation for Informed Medical Decision MakingBostonUSA
  5. 5.HSR&D Center of ExcellenceVA Ann Arbor Healthcare SystemAnn ArborUSA
  6. 6.Division of General Internal MedicineUniversity of MichiganAnn ArborUSA

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