title: Continuing cancer screening later in life: attitudes and intentions among older adults in England.
abstract: BACKGROUND
  the rise in life expectancy, together with age-related increase in the incidence of most cancers, has led to mounting interest in cancer screening in older people. In England, routine invitations stop and an 'opt-in' (individual request) process is available from ages 71 to 76 years for breast and colorectal screening respectively. Little is known about public attitudes towards age-stoppage policy.
  
  
  OBJECTIVE
  this study examined public attitudes to current stoppage policy, information preferences and intentions to request screening beyond the age of routine invitations.
  
  
  METHODS
  participants (n = 927; age 60-74 years) were recruited as part of a TNS Research International survey and took part in home-based, computer-assisted interviews.
  
  
  METHODS
  measures included: (i) attitudes towards current stoppage policy, (ii) preference for communications about screening after the end of the routine invitation period and (iii) intention to opt-in.
  
  
  RESULTS
  the majority of respondents (78%) did not agree with age-based stoppage policies. Most (83%) wanted a strong recommendation to opt-in after this age, although the number who thought they would follow such a recommendation was much lower (27%). A majority of participants (54%) thought information on screening at older ages should come from their general practitioner (GP).
  
  
  CONCLUSIONS
  this survey indicates that older people in England wish to continue to be actively invited for cancer screening, although only a minority think that they would ultimately take up the offer. Primary care may play a role in negotiating a shared decision that is based on individual circumstances.
authors.affiliation: Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, Gower Street, London WC1E 6BT, UK.
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
authors.forename: Ana
authors.initials: A
authors.lastname: Macedo
authors.forename: Christine
authors.initials: C
authors.lastname: Campbell
authors.forename: Alice E
authors.initials: AE
authors.lastname: Simon
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.forename: Victoria
authors.initials: V
authors.lastname: Hammersley
authors.forename: David
authors.initials: D
authors.lastname: Weller
authors.forename: Jo
authors.initials: J
authors.lastname: Waller
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000523:psychology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D004739:England / Q000453:epidemiology; D005260:Female; D058005:General Practitioners; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008017:Life Expectancy; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010819:Physician's Role; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011639:Public Opinion
keywords: cancer screening stoppage; older age; older people; opt-in policy