Article

Awareness of the 2009 US Preventive Services Task Force recommended changes in mammography screening guidelines, accuracy of awareness, sources of knowledge about recommendations, and attitudes about updated screening guidelines in women ages 40--49 and 50+

BMC Public Health (Impact Factor: 2.32). 10/2012; 12(1):899. DOI: 10.1186/1471-2458-12-899
Source: PubMed

ABSTRACT BACKGROUND: The US Preventive Services Task Force updated mammography recommendations in 2009, recommending against routine screening for women ages 40--49 and reducing recommended frequency for women 50+. The recommendation changes were highly controversial and created conflicting recommendations across professional organizations. This study examines overall awareness of the changes, accuracy of knowledge about changes, factors related to both overall awareness and accuracy, sources of knowledge about changes, and attitudes about the new recommendations. METHOD: National telephone survey of 508 women, half aged 40--49 and half 50+, conducted one year after the update (November/December 2010; cooperation rate was 36%). Measures include awareness, accuracy, source of knowledge, interactions with providers, and attitudes about the changes. RESULTS: Fewer than half of women were aware of the guideline changes. Younger, more educated, and higher income women were more aware. Of those who were aware, only 12% correctly reported both change in age and frequency. Accuracy was not associated with demographics. The majority learned of changes through the media and the majority had negative attitudes about the changes. CONCLUSIONS: Despite widespread coverage of the recommendation changes, overall awareness in the relevant population is low. Increasing awareness and addressing attitudes about the changes is necessary to ensure the use of recommendations to impact screening behavior.

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    ABSTRACT: The 2009 U.S. Preventive Services Task Force (USPSTF) changed mammography guidelines to recommend routine biennial screening starting at age 50. This study describes women's awareness of, attitudes toward, and intention to comply with these new guidelines. Women ages 40-50 years old were recruited from the Boston area to participate in focus groups (k = 8; n = 77). Groups were segmented by race/ethnicity (Caucasian = 39%; African American = 35%; Latina = 26%), audio-taped, and transcribed. Thematic content analysis was used. Participants were largely unaware of the revised guidelines and suspicious that it was a cost-savings measure by insurers and/or providers. Most did not intend to comply with the change, viewing screening as obligatory. Few felt prepared to participate in shared decision-making or advocate for their preferences with respect to screening. Communication about the rationale for mammography guideline changes has left many women unconvinced about potential disadvantages or limitations of screening. Since further guideline changes are likely to occur with advances in technology and science, it is important to help women become informed consumers of health information and active participants in shared decision-making with providers. Additional research is needed to determine the impact of the USPSTF change on women's screening behaviors and on breast cancer outcomes.
    BMC Public Health 12/2013; 13(1):1169. DOI:10.1186/1471-2458-13-1169 · 2.32 Impact Factor

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