Health care professionals’ practices, perceptions, and awareness regarding breast self-examination.

Abstract

14 Background: In 2009, the United States Preventive Services Task Force (USPSTF) published the revised guidelines for breast cancer screening which recommended against teaching breast self-examination (BSE).The objective of this study was to assess healthcare professionals' practices, perceptions and knowledge in BSE as well as their adherence to the newly revised USPSTF guideline for BSE. Methods: A cross-sectional survey study was carried out in five medical and gynecological practices affiliated with a large academic teaching hospital in western Massachusetts. The survey was sent to all attending- and resident-physicians, nurse practitioners (NPs), physician assistants (PAs), and registered nurses (RNs) working in these medical practices.The survey collected demographic data and inquired about practitioners’ awareness and perceptions of the 2009 USPSTF guidelines. Results: The survey completion rate was 50.7%. Fewer than half of respondents correctly identified the 2009 USPSTF guidelines recommendations for BSE (41.4%). However, among 35 respondents who stated they were aware of USPSTF guidelines, only 37.1% adhered to them. Overall, 70% (95% CI 61.3%, 79.1%) stated that they do teach patients to perform BSE. The most frequent reasons cited for teaching BSE were: “early detection of cancer” (48.0%), and to “empower women”, (37.0%). In univariable analyses, female practitioners were significantly more likely than male practitioners to report teaching BSE (OR 2.64, 95% CI 1.11, 6.29). Other characteristics which showed an association without reaching statistical significance were: ≥ 5 years of practice (OR 1.67, 95% CI 0.70, 3.98); non-physician practitioner (OR 3.5, 95% CI 0.82, 14.93); US Med School (OR 2.20, 95% CI 0.84, 5.75); ever detecting a lump in a patient (OR 2.95, 95% CI 0.80, 10.87), and belief that BSE reduces morbidity and mortality (OR 2.12, 95% CI 0.84, 5.37). Conclusions: Knowledge of, and adherence to, the 2009 USPSTF guidelines related to BSE are relatively low. Despite being aware of the guidelines, some health professionals still taught BSE. Greater efforts should be made to educate healthcare professionals about the 2009 USPSTF guidelines on BSE.