Hospitalized Women’s Perspective on Willingness-to-Screen for Cancers in Relation to Life Expectancy

Abstract

Objective: Life expectancy is an important tool for physicians and patients to determine when medical services for disease prevention should be rendered. Since patients' preference is an important predictor for cancer screening compliance, incorporating life expectancy with cancer screening preferences becomes essential. The purpose of the study is to explore the mean life expectancy duration that hospitalized women expect in order to undergo cancer screening tests.Methods: A cross-sectional bedside survey including the contingent valuation method was used to assess the mean life expectancy among 475 cancer-free hospitalized women aged 50-75 years, which justified their willingness to undergo cancer screening tests. The probit and logistic regression models were used for the analysis in October 2021.Results: A total of 74% of women were willing to undergo cancer screening if the mean life expectancy was 24.3 months (SE = 12.8, p = 0.058). After adjustment for sociodemographic and clinical covariates, hospitalized women were willing to undergo cancer screening if the mean life expectancy was 26.6 months (SE = 13.3, p = 0.045). Race (African American and others vs Caucasians, OR = 2.34, 95% CI: 1.43-3.81) and annual household income <$20,000 (OR = 1.71, 95% CI: 1.02-2.86) were associated with the willingness to undergo cancer screening among hospitalized women.Conclusion: The study's findings suggest that hospitalized women value the prospect of cancer screening tests, given the mean life expectancy of approximately 27 months. Therefore, offering screening tests to nonadherent hospitalized women with a mean life expectancy of 2¼ years, especially to those at high risk for developing cancer, with low income, or women of color, may improve adherence to cancer screening recommendations.

Perceived Barriers Among Clinicians and Older Adults Aged 65 and Older Regarding Use of Life Expectancy to Inform Cancer Screening: A Narrative Review and Comparison

“…We limited this review to literature reporting on older adults aged 65 and older. We acknowledge that other authors have explored adult perspectives on life expectancy in younger populations (e.g., starting at age 50 or 60) and in other contexts (Kobayashi et al, 2017; Shubella et al, 2022; von Wagner et al, 2013). However, it is highly unlikely that people in younger populations face limited life expectancy or decisions to stop cancer screening.…”