许多老年女性接受的乳腺癌筛查超出了指南建议的阈值。消息传递有望减少过度筛查。为了调查消息对老年妇女支持和停止乳腺癌筛查的意图的影响。5 月 12 日至 6 月 19 日，使用具有全国代表性的在线小组进行了 2 波随机临床在线调查试验，2023 年。65 岁或以上未患乳腺癌的女性有资格参加。向一名假设患有严重疾病和功能障碍的老年女性发送了经过试点测试的乳腺癌筛查停止信息。该消息被描述为来自 3 个来源之一（临床医生、新闻报道或家庭成员）。参与者被随机分为 4 组：无消息（第 1 组[对照组]）、第 1 波来自临床医生的单一消息和第 2 波无消息（第 2 组）、来自新闻报道的消息（第 1 波）和临床医生（第 2 波）（第 3 组），以及来自家庭成员（第 1 波）和临床医生（第 2 波）（第 4 组）的消息。支持停止对假设的老年妇女（主要）进行筛查并为自己筛查意图（次要）按 7 分制进行评估，数值越高表明对停止筛查的支持和意图越强。使用方差分析来比较平均值。还探讨了信息对 75 岁或以上参与者和预期寿命不足 10 岁参与者筛查意图的影响。共有 3051 名女性参与了第一波试验。平均 (SD) 年龄为 72.8 (5.9) 岁； 272 名 (8.9%) 为非西班牙裔黑人，2506 名 (82.1%) 为非西班牙裔白人。在这些女性中，2796 名 (91.6%) 完成了第 2 波。与第 1 组（平均分，3.14 [95% CI，2.99-3.29]）相比，第 2 组对第 2 波假设患者停止筛查的支持率显着更高评分，2.68 [95% CI，2.54-2.82]；P < .001）。与第 1 组和第 2 组（均P < .001)。信息对自我筛查意图的影响遵循类似的模式，对 75 岁或以上或预期寿命有限的参与者影响更大。在这项随机临床试验中，停止乳腺癌筛查的信息显着增加了老年女性对停止筛查的支持和意愿。当消息随着时间的推移从多个来源传递时，观察到最强烈的效果。未来的工作需要吸引潜在的消息源来检查多级消息传递策略的可行性和可接受性及其对筛查行为的影响。ClinicalTrials.gov 标识符：NCT05821023。

Many older women are screened for breast cancer beyond guideline-recommended thresholds. Messaging holds promise to reduce overscreening.To investigate the effect of a message on older women's support for and intentions of stopping breast cancer screening.A 2-wave randomized clinical online survey trial using a nationally representative online panel was performed from May 12 to June 19, 2023. Women 65 years or older without breast cancer were eligible to participate.A pilot-tested breast cancer screening cessation message delivered to a hypothetical older woman with serious illnesses and functional impairment. The message was described as from 1 of 3 sources (clinician, news story, or family member). Participants were randomized into 4 groups: no message (group 1 [control]), a single message from a clinician at wave 1 and no message at wave 2 (group 2), a message from a news story (wave 1) and a clinician (wave 2) (group 3), and a message from a family member (wave 1) and a clinician (wave 2) (group 4).Support for stopping screening in the hypothetical older woman (primary) and screening intentions for oneself (secondary) were assessed on 7-point scales, with higher values indicating stronger support for and intentions to stop screening. Means were compared using analysis of variance. The message effect on screening intentions among participants 75 years or older and those with life expectancy of less than 10 years were also explored.A total of 3051 women participated in wave 1 of the trial. The mean (SD) age was 72.8 (5.9) years; 272 (8.9%) were non-Hispanic Black and 2506 (82.1%) were non-Hispanic White. Of these women, 2796 (91.6%) completed wave 2. Group 2 had significantly higher support for screening cessation in the hypothetical patient at wave 2 (mean score, 3.14 [95% CI, 2.99-3.29]) compared with group 1 (mean score, 2.68 [95% CI, 2.54-2.82]; P < .001). The effect was even stronger in group 3 (mean score, 4.23 [95% CI, 4.09-4.38]) and group 4 (mean score, 4.12 [95% CI, 3.97-4.27]) compared with both groups 1 and 2 (all P < .001). Message effects on self-screening intentions followed a similar pattern, with larger effects among participants 75 years or older or with limited life expectancy.In this randomized clinical trial, a breast cancer screening cessation message significantly increased older women's support for and intentions of screening cessation. The strongest effects were observed when the message was delivered over time from multiple sources. Future work needs to engage potential message sources to examine the feasibility and acceptability of multilevel messaging strategies and their effect on screening behavior.ClinicalTrials.gov Identifier: NCT05821023.