Jennifer Corbelli1, Sonya Borrero2, Rachel Bonnema3, Megan McNamara4, Kevin Kraemer5, Doris Rubio5, Irina Karpov6, Melissa McNeil7. 1. Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: corbellija@upmc.edu. 2. Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for Research Health Equity and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Center for Research on Health Care, University of Pittsburgh Center for Research on Health Care, Pittsburgh, Pennsylvania. 3. Division of General Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska. 4. Division of General Internal Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio; Louis Stokes VA Healthcare System, Cleveland, Ohio. 5. Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for Research on Health Care, University of Pittsburgh Center for Research on Health Care, Pittsburgh, Pennsylvania. 6. Center for Research on Health Care, University of Pittsburgh Center for Research on Health Care, Pittsburgh, Pennsylvania. 7. Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
Abstract
BACKGROUND: In 2009, the U.S. Preventive Services Task Force (USPSTF) guidelines for screening mammography changed significantly, and are now in direct conflict with screening guidelines of other major national organizations. The extent to which physicians in different primary care specialties adhere to current USPSTF guidelines is unknown. METHODS: We conducted a cross-sectional web-based survey completed by 316 physicians in internal medicine, family medicine (FM), and gynecology (GYN) from February to April 2012. Survey items assessed respondents' breast cancer screening recommendations in women of different ages at average risk for breast cancer. We used descriptive statistics to generate response distribution for survey items, and logistic regression models to compare responses among specialties. FINDINGS: The response rate was 55.0% (316/575). A majority of providers in internal medicine (65%), FM (64%), and GYN (92%) recommended breast cancer screening starting at age 40 versus 50. A majority of providers in internal medicine (77%), FM (74%), and GYN (98%) recommended annual versus biennial screening. Gynecologists were significantly more likely than both internists and family physicians to recommend initial mammography at age 40 (p ≤ .0001) and yearly mammography (p = .0003). There were no other differences by respondent demographic. CONCLUSIONS: Primary care providers, especially gynecologists, have not implemented USPSTF guidelines. The extent to which these findings may be driven by patient versus provider preferences should be explored. These findings suggest that patients are likely to receive conflicting breast cancer screening recommendations from different providers.
BACKGROUND: In 2009, the U.S. Preventive Services Task Force (USPSTF) guidelines for screening mammography changed significantly, and are now in direct conflict with screening guidelines of other major national organizations. The extent to which physicians in different primary care specialties adhere to current USPSTF guidelines is unknown. METHODS: We conducted a cross-sectional web-based survey completed by 316 physicians in internal medicine, family medicine (FM), and gynecology (GYN) from February to April 2012. Survey items assessed respondents' breast cancer screening recommendations in women of different ages at average risk for breast cancer. We used descriptive statistics to generate response distribution for survey items, and logistic regression models to compare responses among specialties. FINDINGS: The response rate was 55.0% (316/575). A majority of providers in internal medicine (65%), FM (64%), and GYN (92%) recommended breast cancer screening starting at age 40 versus 50. A majority of providers in internal medicine (77%), FM (74%), and GYN (98%) recommended annual versus biennial screening. Gynecologists were significantly more likely than both internists and family physicians to recommend initial mammography at age 40 (p ≤ .0001) and yearly mammography (p = .0003). There were no other differences by respondent demographic. CONCLUSIONS: Primary care providers, especially gynecologists, have not implemented USPSTF guidelines. The extent to which these findings may be driven by patient versus provider preferences should be explored. These findings suggest that patients are likely to receive conflicting breast cancer screening recommendations from different providers.
Authors: Tracy Onega; Jennifer S Haas; Asaf Bitton; Charles Brackett; Julie Weiss; Martha Goodrich; Kimberly Harris; Steve Pyle; Anna N A Tosteson Journal: Am J Manag Care Date: 2017-01 Impact factor: 2.229
Authors: Jennifer S Haas; William E Barlow; Marilyn M Schapira; Charles D MacLean; Carrie N Klabunde; Brian L Sprague; Elisabeth F Beaber; Jane S Chen; Asaf Bitton; Tracy Onega; Kimberly Harris; Anna N A Tosteson Journal: J Gen Intern Med Date: 2017-01-09 Impact factor: 5.128
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Authors: Elisabeth F Beaber; Anna N A Tosteson; Jennifer S Haas; Tracy Onega; Brian L Sprague; Donald L Weaver; Anne Marie McCarthy; Chyke A Doubeni; Virginia P Quinn; Celette Sugg Skinner; Ann G Zauber; William E Barlow Journal: Breast Cancer Res Treat Date: 2016-09-24 Impact factor: 4.872