Physicians' beliefs about effectiveness of cancer screening tests: A national survey of family physicians, general internists, and obstetrician–gynecologists

Abstract

ObjectiveTo study physicians' beliefs about the effectiveness of different tests for cancer screening. MethodsData were examined from the Women's Health Survey of 1574 Family Medicine, Internal Medicine, and Obstetrics–Gynecology physicians to questions about their level of agreement about the clinical effectiveness of different tests for breast, cervical, ovarian, and colorectal cancer screening among average risk women. Data were weighted to the U.S. physician population based on the American Medical Association Masterfile. Multivariable logistic regression identified physician and practice characteristics significantly associated with physicians' beliefs. ResultsThere were 1574 respondents, representing a 62% response rate. The majority of physicians agreed with the effectiveness of mammography for women aged 50–69years, Pap tests for women aged 21–65years, and colonoscopy for individuals aged ≥50years. A substantial proportion of physicians believed that non-recommended tests were effective for screening (e.g., 34.4% for breast MRI and 69.1% for annual pelvic exam). Physicians typically listed their respective specialty organizations as a top influential organization for screening recommendations. ConclusionsThere were several substantial inconsistencies between physician beliefs in the effectiveness of cancer screening tests and the actual evidence of these tests' effectiveness which can lead both to underuse and overuse of cancer screening tests.