Effects of exposure to media messages about limiting breast cancer screening: A qualitative experimental study

OBJECTIVE

Examine how women aged 35-50 respond to messages about limiting cancer screening.

METHODS

A national sample of women aged 35-50 (n = 983) were randomly assigned to read one of four media vignettes: three provided information about potential harms of mammograms using evidence, norms, or an anecdote strategy, and one provided no such information. Participants listed thoughts they had about the message, and after coding these themes, we tested for associations between the themes evoked, message exposure, and mammogram history.

RESULTS

Thematic categories included emotions (8 %); behavioral intentions (14 %); and cognitions, attitudes, and beliefs (67 %). Pro-screening attitudes, questioning, and cues to get screened were most prevalent. The anecdote message often elicited pro-screening attitudes, while the evidence message often elicited negative emotions and anger, as well as questioning or skeptical responses. Those with a history of mammograms expressed more pro-screening attitudes and disagreed with the message more often.

CONCLUSIONS

Media messaging about guideline-supported care, especially when it involves reducing a clinical service that is routine and valued by patients, may evoke counterarguing, skepticism, and other negative responses.

PRACTICE IMPLICATIONS

Clinicians should recognize the role of the media in potentially shaping women's attitudes, beliefs, and intentions when it comes to breast cancer screening.

Nutrition as prevention for improved cancer health outcomes: a systematic literature review

BACKGROUND

Among adults with cancer, malnutrition is associated with decreased treatment completion, more treatment harms and use of health care, and worse short-term survival. To inform the National Institutes of Health Pathways to Prevention workshop, "Nutrition as Prevention for Improved Cancer Health Outcomes," this systematic review examined the evidence for the effectiveness of providing nutrition interventions before or during cancer therapy to improve outcomes of cancer treatment.

METHODS

We identified randomized controlled trials enrolling at least 50 participants published from 2000 through July 2022. We provide a detailed evidence map for included studies and grouped studies by broad intervention and cancer types. We conducted risk of bias (RoB) and qualitative descriptions of outcomes for intervention and cancer types with a larger volume of literature.

RESULTS

From 9798 unique references, 206 randomized controlled trials from 219 publications met the inclusion criteria. Studies primarily focused on nonvitamin or mineral dietary supplements, nutrition support, and route or timing of inpatient nutrition interventions for gastrointestinal or head and neck cancers. Most studies evaluated changes in body weight or composition, adverse events from cancer treatment, length of hospital stay, or quality of life. Few studies were conducted within the United States. Among intervention and cancer types with a high volume of literature (n = 114), 49% (n = 56) were assessed as high RoB. Higher-quality studies (low or medium RoB) reported mixed results on the effect of nutrition interventions across cancer and treatment-related outcomes.

CONCLUSIONS

Methodological limitations of nutrition intervention studies surrounding cancer treatment impair translation of findings into clinical practice or guidelines.

Cervical Cancer Screening Among Immigrant and Refugee Women: Scoping-Review and Directions for Future Research

The purpose of this study is to explore existing research on determinants of cervical cancer screening among immigrants and refugees in the U.S. A scoping review was conducted on 77 studies targeting immigrant and/or refugee women in the U.S., investigating factors related to cervical cancer screening. Sixty-three percent of studies were conducted in the past ten years, and included 122,345 women. Studies predominately explored knowledge, beliefs and barriers related to cervical cancer and screening. Common beliefs included fear of cancer, treatment and death. Participants perceived pap smears to be associated with embarrassment, pain and fear. Barriers to screening were reported in three categories: psychosocial (shame and embarrassment), communication (inability to speak in English), and barriers related to access (lack of insurance or primary care provider). Study findings indicate research focused at the individual-level and future research should focus on exploring multilevel influences on cancer screening uptake.