Maria D Thomson1, Laura A Siminoff2. 1. Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, Virginia. Electronic address: mthomson2@vcu.edu. 2. Dean and Laura H. Carnell Professor of Public Health in the College of Health Professions and Social Work, Temple University, Philadelphia, Pennsylvania.
Abstract
BACKGROUND: The utility of mammography screening as an efficacious tool for early detection is being contested owing to the risk of potential harms, including psychological distress and exposure to unnecessary procedures associated with false-positive (FPs) results and overdiagnosis. However, there is little research regarding women's experiences, values, or preferences for participating in mammography programs. Our aim was to explore women's actual experiences of a FP mammography screen and their perceptions of the value, risks and benefits given their recent experience. METHODS: We conducted semistructured interviews with 40 women who experienced a recent FP mammogram. Interviews were recorded and transcribed verbatim. A directed content analysis was used to identify and explore primary themes. Knowledge of breast cancer risk was also assessed. FINDINGS: Receiving a FP mammography screen generated significant worry among 60% (n=24) of women. Yet 70% maintained that mammography screening was necessary despite the worry incurred. Women also described the experience as stimulating greater interest in additional cancer prevention activities (32.5%; n=13) and one-third discussed needing more information about the risks and benefits of mammography screening. Less than one-quarter of women (22.5%; n=9) correctly identified a women's lifetime risk of developing breast cancer; 20% (n=8) overestimated, and 57.5% (n=23) underestimated this risk. CONCLUSION: Women reported needing more information about the risks and benefits of mammography screening, but also considered FP results an acceptable risk. Further, our results suggest that breast cancer screening programs may provide a unique opportunity to deliver additional breast cancer prevention interventions.
BACKGROUND: The utility of mammography screening as an efficacious tool for early detection is being contested owing to the risk of potential harms, including psychological distress and exposure to unnecessary procedures associated with false-positive (FPs) results and overdiagnosis. However, there is little research regarding women's experiences, values, or preferences for participating in mammography programs. Our aim was to explore women's actual experiences of a FP mammography screen and their perceptions of the value, risks and benefits given their recent experience. METHODS: We conducted semistructured interviews with 40 women who experienced a recent FP mammogram. Interviews were recorded and transcribed verbatim. A directed content analysis was used to identify and explore primary themes. Knowledge of breast cancer risk was also assessed. FINDINGS: Receiving a FP mammography screen generated significant worry among 60% (n=24) of women. Yet 70% maintained that mammography screening was necessary despite the worry incurred. Women also described the experience as stimulating greater interest in additional cancer prevention activities (32.5%; n=13) and one-third discussed needing more information about the risks and benefits of mammography screening. Less than one-quarter of women (22.5%; n=9) correctly identified a women's lifetime risk of developing breast cancer; 20% (n=8) overestimated, and 57.5% (n=23) underestimated this risk. CONCLUSION:Women reported needing more information about the risks and benefits of mammography screening, but also considered FP results an acceptable risk. Further, our results suggest that breast cancer screening programs may provide a unique opportunity to deliver additional breast cancer prevention interventions.
Authors: Kevin C Oeffinger; Elizabeth T H Fontham; Ruth Etzioni; Abbe Herzig; James S Michaelson; Ya-Chen Tina Shih; Louise C Walter; Timothy R Church; Christopher R Flowers; Samuel J LaMonte; Andrew M D Wolf; Carol DeSantis; Joannie Lortet-Tieulent; Kimberly Andrews; Deana Manassaram-Baptiste; Debbie Saslow; Robert A Smith; Otis W Brawley; Richard Wender Journal: JAMA Date: 2015-10-20 Impact factor: 56.272