Abstract
Background
This study examined why women and doctors screen for ovarian cancer (OC) contrary to guidelines.
Methods
Surveys, based on the Theoretical Domains Framework (TDF), were sent to women in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab), and family physicians (FPs) and gynecologists who organised their screening.
Results
832 of 1,264 (65.8%) kConFab women responded. 126 (15.1%) had screened in the last two years. Most of these (101, 80.2%) would continue even if their doctor told them it is ineffective. For women, key OC screening motivators operated in the domains of social role and goals (staying healthy for family, 93.9%), emotion and reinforcement (peace of mind, 93.1%) and beliefs about capabilities (tests are easy to have, 91.9%). 252 of 531 (47.5%) clinicians responded; a minority (FPs 45.8%, gynecologists 16.7%) thought OC screening was useful. For gynecologists, the main motivators of OC screening operated in the domains of environmental context (lack of other screening options, 27.6%), and emotion (patient peace of mind, 17.2%, difficulty discontinuing screening, 13.8%). For FPs, the strongest motivators were in the domains of social influence (women ask for these tests, 20.7%), goals (a chance these tests will detect cancer early, 16.4%), emotion (patient peace of mind, 13.8%) and environmental context (no other OC screening options, 11.2%).
Conclusion
Reasons for OC screening are mostly patient driven. Clinician knowledge and practice are discordant. Motivators of OC screening encompass several domains, which could be targeted in interventions to reduce inappropriate ovarian cancer screening.
Estimating the workload associated with symptoms-based ovarian cancer screening in primary care: an audit of electronic medical records
