Younger Women Still Want Mammography Screening

The new mammogram screening guidelines have drawn strong skepticism, which is increased by exposure to media that criticize the guidelines, ac cording to AuTumn Davidson, MD, an obstetrician/gynecologist at the University of Massachusetts Memorial Hospital, Worcester, who presented her study at the 2011 American College of Obstetricians and Gynecologists meeting.

In its 2009 updated recommendations, the US Preventive Services Task Force stated that mammography screening should commence at age 50, not age 40, based in part on the psychological stress associated with false positive results, unnecessary imaging and radiation exposure, unnecessary biopsies, and morbidity associated with diagnosis and treatment of cancer that is not clinically relevant.

“These changes sparked intense debate within the popular media,” Dr Davidson said. “Little is known about American women’s attitudes toward these changes and the effect the popular media has played on shaping them.”

To study this issue, Dr Davidson and colleagues surveyed all women aged 39 to 49 years who presented at 1 of 4 OB/GYN practices in Worcester for annual examinations. Patients were randomized to read 1 of 2 articles selected from the lay press—either an article supporting the 2009 guideline changes or opposing them. After reading these, participants answered questions reflecting their opinion of the guideline changes. The attitudes of the 2 groups were compared.

From 244 survey responses, the investigators determined that 78% of women overestimated their lifetime breast cancer risk, and 89% reported feeling that they should have yearly mammograms in their 40s despite the guideline changes. Women who read the article that was favorable toward the guidelines were less likely to desire early screening (85% vs 92% of those reading the more critical article; P = .05).

The guidelines were considered unsafe by 86% of respondents, and those with a close friend or family member with breast cancer were especially likely to reject the guideline changes. Women with a previous false positive mammogram were also less likely to adhere to the new guidelines, even if their physicians supported the guidelines.

“It seems the media play an important role in shaping public opinion regarding evidence-based medicine,” Dr Davidson said.