Abstract B103: Time for a change in breast cancer screening? A survey of female physicians’ perception of 2009 USPSTF guidelines on breast cancer screening

Abstract

Abstract Objective: To explore the attitudes and compliance of female physicians to the 2009 USPSTF guidelines and its influencing factors. Methods: An anonymous cross-sectional survey was conducted on the SurveyMonkey website with a self-designed questionnaire. Email invitations were sent to the presidents of various organizations including American Medical Association (AMA) to explain the purpose of this survey and to recruit participates. Of the 111 female physicians participated in the survey, 109 completed the questionnaire, resulting in an effective response rate of 98.2%. Results: Mammography (71.7%) and clinical breast examination (67.3%) are the most preferred screening tests of female physicians for women aged 40 to 49 years. Consistent with the results, mammography was considered as “very effective” in reducing breast cancer mortality in women aged 40 to 49 years by 66.7% of respondents, compared with breast self examination (23.4%) and clinical breast examination (24.8%) (P < 0.0001). Logistic regression analysis results showed that the following items “Recommend not to begin routine screening mammography in women aged 40 to 49 years”, “Recommend biennial screening mammography in women aged 50 to 74 years”, and the female physicians’ age would significantly influence the female physicians’ decision on whether or not to follow the 2009 USPSTF guidelines. Conclusion: Our survey reveals that most female physician's unwillingness to follow the 2009 USPSTF guidelines is primarily associated with their opposition to the 2009 USPSTF guidelines not to begin routine screening mammography in women aged 40 to 49 years and to start biennial screening mammography in women aged 50 to 74 years. The concerns about the false positive rate and the cost-effectiveness of breast cancer screening, particularly the routine screening mammography for women aged 40 to 49 years, did not significantly influence the female physicians to follow the 2009 USPSTF guidelines. Based on these findings, we propose the following: 1. Inform women about the harms and benefits of mammography as a component of informed decision making and continue annual screening mammography starting at age 40; 2. Educate the public about breast cancer and the importance of early screening remains a high priority. Personalized risk assessment and screening tailored to risks are our future goals. Although there remains some debate about the optimal age at which to begin screening and the optimal frequency of screening, as more robust evidence and improved technical advances are more readily available, the USPSTF guidelines will be updated. The art and science of medicine continue to be intertwined as physicians attempt to balance their current knowledge with the needs and concerns of their individual patients. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B103.