1
|
Savaridas S, Brook J, Codde J, Bulsara M, Wylie E. The effect of individual radiographers on rates of attendance to breast screening: a 7-year retrospective study. Clin Radiol 2018; 73:413.e7-413.e13. [DOI: 10.1016/j.crad.2017.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/14/2017] [Indexed: 10/18/2022]
|
2
|
What Do Patients Tweet About Their Mammography Experience? Acad Radiol 2016; 23:1367-1371. [PMID: 27658329 DOI: 10.1016/j.acra.2016.07.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 07/16/2016] [Accepted: 07/19/2016] [Indexed: 11/23/2022]
Abstract
RATIONALE AND OBJECTIVE The purpose of this study was to evaluate themes related to patients' experience in undergoing mammography, as expressed on Twitter. METHODS A total of 464 tweets from July to December 2015 containing the hashtag #mammogram and relating to a patient's experience in undergoing mammography were reviewed. RESULTS Of the tweets, 45.5% occurred before the mammogram compared to 49.6% that occurred afterward (remainder of tweets indeterminate). However, in patients undergoing their first mammogram, 32.8% occurred before the examination, whereas in those undergoing follow-up mammogram, 53.0% occurred before the examination. Identified themes included breast compression (24.4%), advising other patients to undergo screening (23.9%), recognition of the health importance of the examination (18.8%), the act of waiting (10.1%), relief regarding results (9.7%), reflection that the examination was not that bad (9.1%), generalized apprehension regarding the examination (8.2%), interactions with staff (8.0%), the gown (5.0%), examination costs or access (3.4%), offering or reaching out for online support from other patients (3.2%), perception of screening as a sign of aging (2.4%), and the waiting room or waiting room amenities (1.3%). Of the tweets, 31.9% contained humor, of which 56.1% related to compression. Themes that were more common in patients undergoing their first, rather than follow-up, mammogram included breast compression (16.4% vs 9.1%, respectively) and that the test was not that bad (26.2% vs 7.6%, respectively). CONCLUSION Online social media provides a platform for women to share their experiences and reactions in undergoing mammography, including humor, positive reflections, and encouragement of others to undergo the examination. Social media thus warrants further evaluation as a potential tool to help foster greater adherence to screening guidelines.
Collapse
|
3
|
Nelson HD, Pappas M, Cantor A, Griffin J, Daeges M, Humphrey L. Harms of Breast Cancer Screening: Systematic Review to Update the 2009 U.S. Preventive Services Task Force Recommendation. Ann Intern Med 2016; 164:256-67. [PMID: 26756737 DOI: 10.7326/m15-0970] [Citation(s) in RCA: 263] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In 2009, the U.S. Preventive Services Task Force recommended biennial mammography screening for women aged 50 to 74 years and selective screening for those aged 40 to 49 years. PURPOSE To review studies of screening in average-risk women with mammography, magnetic resonance imaging, or ultrasonography that reported on false-positive results, overdiagnosis, anxiety, pain, and radiation exposure. DATA SOURCES MEDLINE and Cochrane databases through December 2014. STUDY SELECTION English-language systematic reviews, randomized trials, and observational studies of screening. DATA EXTRACTION Investigators extracted and confirmed data from studies and dual-rated study quality. Discrepancies were resolved through consensus. DATA SYNTHESIS Based on 2 studies of U.S. data, 10-year cumulative rates of false-positive mammography results and biopsies were higher with annual than biennial screening (61% vs. 42% and 7% vs. 5%, respectively) and for women aged 40 to 49 years, those with dense breasts, and those using combination hormone therapy. Twenty-nine studies using different methods reported overdiagnosis rates of 0% to 54%; rates from randomized trials were 11% to 22%. Women with false-positive results reported more anxiety, distress, and breast cancer-specific worry, although results varied across 80 observational studies. Thirty-nine observational studies indicated that some women reported pain during mammography (1% to 77%); of these, 11% to 46% declined future screening. Models estimated 2 to 11 screening-related deaths from radiation-induced cancer per 100,000 women using digital mammography, depending on age and screening interval. Five observational studies of tomosynthesis and mammography indicated increased biopsies but reduced recalls compared with mammography alone. LIMITATIONS Studies of overdiagnosis were highly heterogeneous, and estimates varied depending on the analytic approach. Studies of anxiety and pain used different outcome measures. Radiation exposure was based on models. CONCLUSION False-positive results are common and are higher for annual screening, younger women, and women with dense breasts. Although overdiagnosis, anxiety, pain, and radiation exposure may cause harm, their effects on individual women are difficult to estimate and vary widely. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality.
Collapse
Affiliation(s)
- Heidi D. Nelson
- From the Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; Veterans Affairs Portland Health Care System; and Providence Cancer Center, Providence Health & Services, Portland, Oregon
| | - Miranda Pappas
- From the Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; Veterans Affairs Portland Health Care System; and Providence Cancer Center, Providence Health & Services, Portland, Oregon
| | - Amy Cantor
- From the Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; Veterans Affairs Portland Health Care System; and Providence Cancer Center, Providence Health & Services, Portland, Oregon
| | - Jessica Griffin
- From the Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; Veterans Affairs Portland Health Care System; and Providence Cancer Center, Providence Health & Services, Portland, Oregon
| | - Monica Daeges
- From the Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; Veterans Affairs Portland Health Care System; and Providence Cancer Center, Providence Health & Services, Portland, Oregon
| | - Linda Humphrey
- From the Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; Veterans Affairs Portland Health Care System; and Providence Cancer Center, Providence Health & Services, Portland, Oregon
| |
Collapse
|
4
|
Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome. Eur Radiol 2015; 25:2821-9. [DOI: 10.1007/s00330-015-3711-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 02/16/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
|
5
|
Karimi P, Shahrokni A, Moradi S. Evidence for U.S. Preventive Services Task Force (USPSTF) recommendations against routine mammography for females between 40-49 years of age. Asian Pac J Cancer Prev 2014; 14:2137-9. [PMID: 23679332 DOI: 10.7314/apjcp.2013.14.3.2137] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Breast cancer is the most common cancer among females, worldwide, accounting for 22.9% of all cancers (excluding non-melanoma skin cancer) in women. Mammography is a sensitive (77-95%) and specific (94-97%) screening method for breast cancer. Previously, females between the 40-50 years old were recommended to have mammograms every one to two years. However, based on current evidence, in 2009, USPSTF recommended that the decision to start regular, biennial screening mammography for females younger than 50 years should be an individual decision and take patient context into account, including patient values regarding specific benefits and harms. This decision was based on findings regarding radiation exposure, false-positive and false-negative rates, over-diagnosis, and pain and psychological responses. The goal of this paper is to focus on evidence for updating the U.S. Preventive Services Task Force (USPSTF) recommendation against routine mammography for females between 40-49 years of age.
Collapse
Affiliation(s)
- Parisa Karimi
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
| | | | | |
Collapse
|
6
|
Whelehan P, Evans A, Wells M, MacGillivray S. The effect of mammography pain on repeat participation in breast cancer screening: A systematic review. Breast 2013; 22:389-94. [DOI: 10.1016/j.breast.2013.03.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 02/20/2013] [Accepted: 03/03/2013] [Indexed: 11/29/2022] Open
|
7
|
Shaw SJ, Vivian J, Orzech KM, Torres CH, Armin J. Consistency in attitudes across cancer screenings in medically underserved minority populations. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:165-71. [PMID: 22105657 PMCID: PMC4160142 DOI: 10.1007/s13187-011-0285-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
UNLABELLED While a wide range of behavioral and psychosocial literature explores attitudes and beliefs towards cancer screenings, fewer studies examine attitudes across cancer screening types. We draw on quantitative and qualitative findings from a 4-year prospective study based at a community health center serving diverse, low-income patients. Methods included self-report surveys (n = 297), medical chart abstraction, and several qualitative methods with a subsample of participants. Participants included white, African-American, Vietnamese, and Latino patients who were diagnosed with diabetes, hypertension, or both. Patients' attitudes (both positive and negative) towards cancer screening types were remarkably consistent across cancer screening types. These effects were stronger among men than women. Never having had a cancer screening was generally associated with more unfavorable attitudes towards all screenings. Qualitative interviews indicate the importance of information circulated through social networks in shaping attitudes towards cancer screenings. CONDENSED ABSTRACT In a multi-method study of attitudes towards cancer screening among medically underserved patients in a primary care setting, we found that attitudes (both positive and negative) were remarkably consistent across cancer screening types.
Collapse
Affiliation(s)
- Susan J. Shaw
- School of Anthropology, University of Arizona, P.O. Box 210030, Tucson, AZ 85721-0030, USA
| | - James Vivian
- Department of Psychology, University of Hartford, Hartford, CT 06117, USA
| | - Kathryn M. Orzech
- Department of Psychiatry and Human Behavior, Brown University, Box G-BH, Providence, RI 02912, USA
- Chronobiology and Sleep Research Laboratory, E. P. Bradley Hospital, Providence, RI, USA
| | - Cristina Huebner Torres
- Community Programs and Research, Caring Health Center, 1145 Main Street, Springfield, MA 01103, USA
| | - Julie Armin
- School of Anthropology, University of Arizona, P.O. Box 210030, Tucson, AZ 85721-0030, USA
| |
Collapse
|
8
|
Affiliation(s)
- Ellen Warner
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada.
| |
Collapse
|
9
|
Llewellyn G, Balandin S, Poulos A, McCarthy L. Disability and mammography screening: intangible barriers to participation. Disabil Rehabil 2011; 33:1755-67. [PMID: 21219085 DOI: 10.3109/09638288.2010.546935] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The aim of this study was to investigate intangible or non-physical barriers to participation of women with disability in mammography screening. METHOD Women with disability were recruited via specific advocacy and support organisations in New South Wales, Australia. Interviews were conducted which focused on issues relating to participants' experience with breast screening services. RESULTS A total of 75 women with varying degrees of disability agreed to participate. Three key intangible barriers were identified related to the women's expectations to be informed, to be involved and to be treated with respect. Details of the content, type, timing of appropriately presented information as well as who should provide it were emphasised. Barriers to active involvement to manage their disability and take control over their experience were identified. The women also indicated the specific treatment they received from screening staff which negatively impacted on their experience. CONCLUSIONS This study has provided important and clinically significant detail of intangible barriers to participation in screening mammography experienced by women with physical disability. These study outcomes suggest ways in which the satisfaction with the mammogram experience can be increased for these women and contribute to increased participation in mammography screening.
Collapse
Affiliation(s)
- Gwynnyth Llewellyn
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | | | | | | |
Collapse
|
10
|
Drossaert CHC, Boer H, Seydel ER. Women's opinions about attending for breast cancer screening: Stability of cognitive determinants during three rounds of screening. Br J Health Psychol 2010; 10:133-49. [PMID: 15826339 DOI: 10.1348/135910704x14645] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine the stability of beliefs and intentions towards repeat attendance at breast cancer screening, using the Theory of Planned Behaviour. The aims of the study were to examine whether and how cognitions changed in the course of the programme, and whether intentions that were assessed proximally were better predictors of behaviour than those assessed distally. DESIGN AND METHODS A total of 2,657 women filled out a baseline questionnaire (T(1)), 2 months after being invited for an initial mammogram in the Dutch Breast Cancer Screening Programme. Actual attendance data in the second and third screening rounds were subsequently collected and follow-up questionnaires were sent to parts of the sample at four points in time: shortly before (T(2)) and after (T(3)) the second screening round, and shortly before (T(4)) and after (T(5)) the third screening round. RESULTS Only minor changes in beliefs and intentions were found. In the assessments shortly before screening, women were somewhat less positive about attending than in the assessments shortly after screening. Throughout the course of the programme, women's opinions about attending remained positive. In fact, women became somewhat more convinced that they were vulnerable to getting breast cancer, and that participating in screening was beneficial to them. Actual attendance in subsequent rounds of screening was higher than expected. Proximal beliefs and intentions were only slightly more predictive of actual behaviour than distal beliefs. CONCLUSIONS In organized breast cancer screening, beliefs and intentions remain positive and rather stable. Although our results should be interpreted with caution, due to little variation in behaviour, they suggest that the gap between intentions and behaviour could not be substantially reduced by proximal assessment of determinants.
Collapse
Affiliation(s)
- C H C Drossaert
- Twente Institute of Communication Research, Enschede, The Netherlands.
| | | | | |
Collapse
|
11
|
Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L. Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med 2010. [PMID: 19920273 DOI: 10.1059/0003-4819-151-10-200911170-00009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND This systematic review is an update of evidence since the 2002 U.S. Preventive Services Task Force recommendation on breast cancer screening. PURPOSE To determine the effectiveness of mammography screening in decreasing breast cancer mortality among average-risk women aged 40 to 49 years and 70 years or older, the effectiveness of clinical breast examination and breast self-examination, and the harms of screening. DATA SOURCES Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the fourth quarter of 2008), MEDLINE (January 2001 to December 2008), reference lists, and Web of Science searches for published studies and Breast Cancer Surveillance Consortium for screening mammography data. STUDY SELECTION Randomized, controlled trials with breast cancer mortality outcomes for screening effectiveness, and studies of various designs and multiple data sources for harms. DATA EXTRACTION Relevant data were abstracted, and study quality was rated by using established criteria. DATA SYNTHESIS Mammography screening reduces breast cancer mortality by 15% for women aged 39 to 49 years (relative risk, 0.85 [95% credible interval, 0.75 to 0.96]; 8 trials). Data are lacking for women aged 70 years or older. Radiation exposure from mammography is low. Patient adverse experiences are common and transient and do not affect screening practices. Estimates of overdiagnosis vary from 1% to 10%. Younger women have more false-positive mammography results and additional imaging but fewer biopsies than older women. Trials of clinical breast examination are ongoing; trials for breast self-examination showed no reductions in mortality but increases in benign biopsy results. LIMITATION Studies of older women, digital mammography, and magnetic resonance imaging are lacking. CONCLUSION Mammography screening reduces breast cancer mortality for women aged 39 to 69 years; data are insufficient for older women. False-positive mammography results and additional imaging are common. No benefit has been shown for clinical breast examination or breast self-examination.
Collapse
Affiliation(s)
- Heidi D Nelson
- Oregon Health & Science University, Veterans Affairs Medical Center, Portland, OR 97239-3098, USA.
| | | | | | | | | | | |
Collapse
|
12
|
Jeon BY, Lee HY, Park EC, Choi KS, Jun JK, Kim Y, Han MA, Yoon NH, Kim EJ, Jeon SM. Satisfaction with mammography in the National Cancer Screening Programme participants of age 40s in Korea. Eur J Cancer Care (Engl) 2010; 20:803-9. [PMID: 20649810 DOI: 10.1111/j.1365-2354.2010.01210.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to evaluate satisfaction with the National Cancer Screening Programme of mammography in Korea and to examine the association between subscales of satisfaction and general satisfaction. We conducted a cross-sectional telephone survey for women who had obtained a National Cancer Screening Programme mammographic screening at general hospitals between May and October 2008. The present study included 2005 women in their forties. We performed multivariate linear regression using dependent variable as general satisfaction and independent variables as subscales of satisfaction, such as pre-screening information transfer, staff interpersonal skills, physical surroundings and results reporting. Participants were stratified according to the result of their mammogram as negative or positive. Mean score of satisfaction was above 2.5 of 4 for all subscales. Women who received positive results were less satisfied with all of subscale factors. Staff interpersonal skills were the most important factor that contributed to general satisfaction. Future efforts such as staff training programme of communication/attitude skills, ensuring privacy and explanation of possible discomfort of the screening would be needed.
Collapse
Affiliation(s)
- B Y Jeon
- National Cancer Control Research Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Gillan MGC, Gilbert FJ, Flight H, Cooper J, Wallis MG, James JJ, Boggis CRM, Astley SM, Agbaje OF, Duffy SW. Increasing participant recruitment into large-scale screening trials: experience from the CADET II study. J Med Screen 2009; 16:180-5. [DOI: 10.1258/jms.2009.009023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives Multicentre randomized trials frequently encounter difficulties in meeting their recruitment targets, resulting in extension of the trial and delays in implementation of the findings. We report on recruitment strategies implemented in a randomized evaluation of computer-aided detection in women attending routine screening in the UK Breast Screening Programme. Setting The target population for the trial was identified from an existing NHS database of women aged 50–70 invited for routine mammography in Coventry, Manchester and Nottingham, UK. Women were asked to consent to their mammograms being randomly allocated (in a ratio of 28:1:1) to one of three film-reading protocols. Trial information was mailed to women, along with the invitation to attend screening, and informed consent was obtained at the mammography appointment. Several strategies were implemented to increase recruitment rates. Results Recruitment rate increased significantly over time in the study ( P < 0.0010 in all centres) with an overall acceptance rate of 46% of those attending screening. Mailing of the trial information sheet separate from the screening invitation in Coventry and Nottingham increased the recruitment rate, even after adjustment for the trend over time and for socioeconomic status of the attendees ( P < 0.001). Extension of recruitment to mobile screening units in Nottingham, and the presence of an additional member of staff also improved recruitment ( P < 0.001). Simplification of the trial information sheet had little effect. Increases in recruitment rate were not attributable to socioeconomic status of the attendees. Conclusions In multicentre trials, monitoring of local recruitment protocols is required to ensure that each centre can maximize accrual targets.
Collapse
Affiliation(s)
- Maureen G C Gillan
- Research Fellow, Aberdeen Biomedical maging Centre, University of Aberdeen, Aberdeen, UK
| | - Fiona J Gilbert
- Consultant Radiologist, Aberdeen Biomedical maging Centre, University of Aberdeen, Aberdeen, UK
| | - Helen Flight
- Research Assistant, Christie NHS Foundation Trust, Manchester, UK
| | - Joanna Cooper
- Secretary, Nottingham Breast Institute, Nottingham City Hospital, Nottingham, UK
| | - Matthew G Wallis
- Consultant Radiologist, Cambridge Breast Unit and Biomedical Research Centre, Addenbrookes Hospital, Cambridge, UK
| | - Jonathan J James
- Consultant Radiologist, Nottingham Breast Institute, Nottingham City Hospital, Nottingham, UK
| | - Caroline R M Boggis
- Consultant Radiologist, Nightingale Centre, Wythenshawe Hospital, Manchester, UK
| | - Susan M Astley
- Reader in Imaging Science, Department of maging Science & Biomedical Engineering, University of Manchester, UK
| | - Olorunsola F Agbaje
- Senior Medical Statistician, Division of Cancer Studies, Cancer Epidemiology Unit, King's College London, School of Medicine, London, UK
| | - Stephen W Duffy
- Professor of Cancer Screening, Department of Epidemiology, Mathematics & Statistics, Wolfson Institute of Preventive Medicine, London, UK
| |
Collapse
|
14
|
Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L. Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med 2009; 151:727-37, W237-42. [PMID: 19920273 PMCID: PMC2972726 DOI: 10.7326/0003-4819-151-10-200911170-00009] [Citation(s) in RCA: 774] [Impact Index Per Article: 51.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND This systematic review is an update of evidence since the 2002 U.S. Preventive Services Task Force recommendation on breast cancer screening. PURPOSE To determine the effectiveness of mammography screening in decreasing breast cancer mortality among average-risk women aged 40 to 49 years and 70 years or older, the effectiveness of clinical breast examination and breast self-examination, and the harms of screening. DATA SOURCES Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the fourth quarter of 2008), MEDLINE (January 2001 to December 2008), reference lists, and Web of Science searches for published studies and Breast Cancer Surveillance Consortium for screening mammography data. STUDY SELECTION Randomized, controlled trials with breast cancer mortality outcomes for screening effectiveness, and studies of various designs and multiple data sources for harms. DATA EXTRACTION Relevant data were abstracted, and study quality was rated by using established criteria. DATA SYNTHESIS Mammography screening reduces breast cancer mortality by 15% for women aged 39 to 49 years (relative risk, 0.85 [95% credible interval, 0.75 to 0.96]; 8 trials). Data are lacking for women aged 70 years or older. Radiation exposure from mammography is low. Patient adverse experiences are common and transient and do not affect screening practices. Estimates of overdiagnosis vary from 1% to 10%. Younger women have more false-positive mammography results and additional imaging but fewer biopsies than older women. Trials of clinical breast examination are ongoing; trials for breast self-examination showed no reductions in mortality but increases in benign biopsy results. LIMITATION Studies of older women, digital mammography, and magnetic resonance imaging are lacking. CONCLUSION Mammography screening reduces breast cancer mortality for women aged 39 to 69 years; data are insufficient for older women. False-positive mammography results and additional imaging are common. No benefit has been shown for clinical breast examination or breast self-examination.
Collapse
Affiliation(s)
- Heidi D Nelson
- Oregon Health & Science University, Veterans Affairs Medical Center, Portland, OR 97239-3098, USA.
| | | | | | | | | | | | | |
Collapse
|
15
|
Tang TS, Patterson SK, Roubidoux MA, Duan L. Women's mammography experience and its impact on screening adherence. Psychooncology 2009; 18:727-34. [PMID: 19035468 DOI: 10.1002/pon.1463] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Although rates for first-time and recent mammography screening have increased for women in the US in the past decade, rates for repeat mammography remain low. This study aimed to conduct an analysis of women's mammography experience, to examine the rates of repeat mammography and to identify the significant predictors of repeat mammography within 12 and 18 months of the index mammogram. METHODS Participants were 397 women obtaining a screening mammogram (i.e. index) at three university-affiliated radiology clinics. Following the index mammogram, women completed the measures assessing demographic background, health history, breast cancer knowledge, risk, and screening history, and aspects of the mammography experience. Eighteen months following the index mammogram, 296 women were contacted via telephone to assess repeat mammography behavior. RESULTS Factor analysis of a mammography experience survey yielded four major components including satisfaction with clinic services, physical experience, psychological experience, and communication with clinic staff. Twelve-month and 18-month repeat mammography rates were 37 and 68%, respectively. Logistic regression models found lifetime number of mammograms to predict repeat mammography at 12 and 18 months. In addition, the number of clinical breast exams obtained in the past 5 years predicted repeat mammography at 12 months, while having scheduled a mammography appointment predicted repeat mammography at 18 months. CONCLUSIONS Based on these findings, strategies to increase mammography adherence include implementing a formal reminder system that prompts patients (e.g. postcard, automated telephone call) to schedule an annual mammogram or training clinic staff to automatically schedule an annual mammogram at the time of the current screening appointment.
Collapse
Affiliation(s)
- Tricia S Tang
- Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI 48109-5201, USA.
| | | | | | | |
Collapse
|
16
|
de Gelder R, van As E, Tilanus-Linthorst MMA, Bartels CCM, Boer R, Draisma G, de Koning HJ. Breast cancer screening: evidence for false reassurance? Int J Cancer 2008; 123:680-6. [PMID: 18484587 DOI: 10.1002/ijc.23540] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Tumour stage distribution at repeated mammography screening is, unexpectedly, often not more favourable than stage distribution at first screenings. False reassurance, i.e., delayed symptom presentation due to having participated in earlier screening rounds, might be associated with this, and unfavourably affect prognosis. To assess the role of false reassurance in mammography screening, a consecutive group of 155 breast cancer patients visiting a breast clinic in Rotterdam (The Netherlands) completed a questionnaire on screening history and self-observed breast abnormalities. The length of time between the initial discovery of breast abnormalities and first consultation of a general practitioner ("symptom-GP period") was compared between patients with ("screening group") and without a previous screening history ("control group"), using Kaplan-Meier survival curves and log-rank testing. Of the 155 patients, 84 (54%) had participated in the Dutch screening programme at least once before tumour detection; 32 (38%) of whom had noticed symptoms. They did not significantly differ from control patients (n = 42) in symptom-GP period (symptom-GP period > or = 30 days: 31.2% in the symptomatic screened group, 31.0% in the control group; p = 0.9). Only 2 out of 53 patients (3.8%) with screen-detected cancer had noticed symptoms prior to screening, reporting symptom-GP periods of 2.5 and 4 years. The median period between the first GP- and breast clinic visit was 7.0 days (95% C.I. 5.9-8.1) in symptomatic screened patients and 6.0 days (95% C.I. 4.0-8.0) in control patients. Our results show that false reassurance played, at most, only a minor role in breast cancer screening.
Collapse
Affiliation(s)
- Rianne de Gelder
- Department of Public Health, Erasmus MC, 3000 CA Rotterdam, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
17
|
Bonomi AE, Boudreau DM, Fishman PA, Ludman E, Mohelnitzky A, Cannon EA, Seger D. Quality of life valuations of mammography screening. Qual Life Res 2008; 17:801-14. [PMID: 18491217 DOI: 10.1007/s11136-008-9353-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Accepted: 04/21/2008] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To obtain quality-of-life (QOL) valuations associated with mammography screening and breast cancer treatment that are suitable for use in cost-effectiveness analyses. METHODS Subjects comprised 131 women (age range 50-79 years) randomly sampled from a breast cancer screening program. In an in-person or telephone interview, women rated the QOL impact of 14 clinical scenarios (ranging from mammography to end-of-life care for breast cancer) using a visual analogue scale anchored by death (0) and perfect health/quality of life (100). RESULTS Women rated the scenarios describing true negative results, false positive results, and routine screening mammography at 80 or above on a scale of 0-100, suggesting that they perceive these states as being close to perfect health. They rated adjuvant chemotherapy (39.7; range 10-90), palliation/end-of-life care (35.8; range 0-100), and recurrence at 1 year (33.0; range 0-95) the lowest, suggesting that these health states are perceived as compromised. Women rated receiving news of a breast cancer diagnosis (true positive) (45.7; range 5-100) and receiving delayed news of a breast cancer diagnosis (false negative) (48.5; range 5-100) as being comparable to undergoing mastectomy (48.3; range 10-100) and radiation therapy (46.2; range 5-100) for breast cancer. CONCLUSIONS These data can be used to update cost analyses of mammography screening that wish to take into account the QOL impact of screening.
Collapse
Affiliation(s)
- Amy E Bonomi
- Human Development and Family Science, The Ohio State University, 135 Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210, USA.
| | | | | | | | | | | | | |
Collapse
|
18
|
Saladié F, Poblet C, Sirgo A, Galceran J. Women's satisfaction with the breast cancer screening programme in Tarragona, Spain. Breast J 2008; 14:315-6. [PMID: 18476891 DOI: 10.1111/j.1524-4741.2008.00586.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
19
|
Abstract
The authors discuss the available data on the effects of communicating aggregate and individual research results on participants, investigators, and the research enterprise.
Collapse
Affiliation(s)
- David I Shalowitz
- Bioethics Program, University of Michigan Medical School, Ann Arbor, Michigan, United States of America.
| | | |
Collapse
|
20
|
The Socio-Politics of Technology and Innovation: Problematizing the ‘Caring’ in Healthcare? SOCIAL THEORY & HEALTH 2006. [DOI: 10.1057/palgrave.sth.8700078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
21
|
Brett J, Bankhead C, Henderson B, Watson E, Austoker J. The psychological impact of mammographic screening. A systematic review. Psychooncology 2006; 14:917-38. [PMID: 15786514 DOI: 10.1002/pon.904] [Citation(s) in RCA: 201] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Concerns have been raised regarding the possible negative psychological impact of the cancer screening programmes offered in the UK. This review aims to assess the extent of and factors associated with the adverse psychological consequences of mammographic screening. Fifty-four papers from 13 countries were identified, a majority of which were published after 1990, coinciding more or less with the onset of routine mammographic screening. The results report that mammographic screening does not appear to create anxiety in women who are given a clear result after a mammogram and are subsequently placed on routine recall. However, women who have further investigations following their routine mammogram experience significant anxiety in the short term, and possibly in the long term. The nature and extent of the further investigation that women are exposed to during mammographic screening determines the intensity of the psychological impact. Factors associated with the adverse psychological impact of mammographic screening included: social demographic factors of younger age, lower education, living in urban areas, manual occupation, and one or no children; cancer screening factors of dissatisfaction with information and communication during screening process, waiting time between recall letter and recall appointment, pain experienced during the mammographic screening procedures, and previous false positive result; and cancer worry factors including fear of cancer and greater perceived risk of breast cancer. Difficulties in measuring the psychological impact of screening are discussed, and methods of alleviating the negative psychological outcomes are suggested.
Collapse
Affiliation(s)
- J Brett
- Cancer Research UK Primary Care Education Research Group, Department of Primary Care, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK
| | | | | | | | | |
Collapse
|
22
|
Soler-Michel P, Courtial I, Bremond A. Participation secondaire des femmes au dépistage organisé du cancer du sein. Rev Epidemiol Sante Publique 2005; 53:549-67. [PMID: 16434928 DOI: 10.1016/s0398-7620(05)84731-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In France, breast cancer is the most frequently occurring cancer and the leading cause of cancer deaths in women. Breast cancer screening has been shown to reduce breast cancer mortality by 30% provided attendance rate is 70% and re-screening interval is two to three years. Maintaining a high rate of reattendance is also important. The decline with time of completion rates of re-screening will lessen the benefits of a breast cancer screening program. METHODS A review of published studies examining factors associated with attendance and reattendance to breast cancer screening. RESULTS Positive views about initial screening are determining factors in reattendance: mammography should not be painful and embarrassing, appointments should be punctual and clinic staff courteous and supportive. Psychological factors influencing attendance also influence reattendance as does intention to participate, a major predictor of repeat participation and as do perceived susceptibility of breast cancer, perceived benefits of mammography, absence of emotional barriers. These factors can be modified by experience of previous screening. Other predicting factors of attendance continue to influence reattendance: practice of other preventive health behaviors, outside support from physicians, knowledge of breast cancer and screening. CONCLUSION A better understanding of factors influencing attendance is necessary to increase the impact of breast cancer screening. Field studies are necessary to support the elaboration of publicity campaigns aimed at increasing participation.
Collapse
Affiliation(s)
- P Soler-Michel
- Adémas-69, Association pour le dépistage des maladies du sein du Rhône, 28, rue Servient, 69003 Lyon.
| | | | | |
Collapse
|
23
|
Barratt A, Howard K, Irwig L, Salkeld G, Houssami N. Model of outcomes of screening mammography: information to support informed choices. BMJ 2005; 330:936. [PMID: 15755755 PMCID: PMC556337 DOI: 10.1136/bmj.38398.469479.8f] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To provide easy to use estimates of the benefits and harms of biennial screening mammography for women aged 40, 50, 60, and 70 years. DESIGN Markov process model, with data from BreastScreen Australia, the Australian Institute of Health and Welfare, and the Australian Bureau of Statistics. MAIN OUTCOME MEASURE Age specific outcomes expressed per 1000 women over 10 years. RESULTS For every 1000 women screened over 10 years, 167-251 (depending on age) receive an abnormal result; 56-64 of these women undergo at least one biopsy, 9-26 have an invasive cancer detected by screening, and 3-6 have ductal carcinoma in situ (DCIS) detected by screening. More breast cancers (both invasive and DCIS) are diagnosed among screened than unscreened women. For example, among 1000 women aged 50 who have five biennial screens, 33 breast cancers are diagnosed: 28 invasive cancers (18 detected at screening and 10 interval cancers) and five DCIS (all detected at screening). By comparison, among 1000 women aged 50 who decline screening, 20 cancers are diagnosed over 10 years. There are about 0.5, 2, 3, and 2 fewer deaths from breast cancer over 10 years per 1000 women aged 40, 50, 60, and 70, respectively, who choose to be screened compared with women who decline screening at times determined by relevant policy. CONCLUSION Benefits and harms of screening mammography are relatively finely balanced. Quantitative estimates such as these can be used to support individual informed choices about screening.
Collapse
Affiliation(s)
- Alexandra Barratt
- Screening and Test Evaluation Program, School of Public Health, University of Sydney, NSW 2006, Australia.
| | | | | | | | | |
Collapse
|
24
|
Engelman KK, Ellerbeck EF, Mayo MS, Markello SJ, Ahluwalia JS. Mammography facility characteristics and repeat mammography use among Medicare beneficiaries. Prev Med 2004; 39:491-7. [PMID: 15313088 DOI: 10.1016/j.ypmed.2004.05.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The goal of this study was to examine mammography facility characteristics and explore how such characteristics may impact repeat mammography use. METHODS Mammography facility characteristics were obtained through a mailed a 21-item survey to Kansas mammography facilities. Medicare mammography claims were used to calculate facility-specific repeat mammography rates. Administrative data included female Kansas beneficiaries aged 65 years and older (N = 39,035) with a baseline mammogram during 1999. Beneficiaries with a mammography claim 12-18 months after their baseline mammogram were deemed to have had a repeat mammogram. RESULTS Completed surveys were received from 90% (N = 79) of the 97 facilities serving >10 beneficiaries. Most facilities were in rural communities (58%), had an on-site radiologist (58%), and mailed mammography reminders to patients (63%). Extended hours of operation and the acceptance of self-referrals were uncommon (33% and 37%, respectively). Few facilities employed a quality improvement team (33%) or measured annual patient return rates (18%), but many measured patient satisfaction (57%). Of the beneficiaries, 61% had a repeat mammogram during the subsequent 12-18 months (range, 0% to 84%). Facilities notifying primary care providers of patients due for mammograms had higher repeat mammography rates. Multiple regression analyses found that higher repeat mammography rates were associated with facilities that accepted self-referrals, measured patient satisfaction, were in urban areas, and served a larger proportion of white beneficiaries. CONCLUSION Mammography facility characteristics and repeat mammography rates vary widely. Although modifiable facility characteristics that may influence repeat mammography need additional study, results from this study indicate that mammography facilities are an opportunistic arena for quality improvement endeavors.
Collapse
Affiliation(s)
- Kimberly K Engelman
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA.
| | | | | | | | | |
Collapse
|
25
|
Carney PA, Kasales CJ, Tosteson ANA, Weiss JE, Goodrich ME, Poplack SP, Wells WS, Titus-Ernstoff L. Likelihood of additional work-up among women undergoing routine screening mammography: the impact of age, breast density, and hormone therapy use. Prev Med 2004; 39:48-55. [PMID: 15207985 DOI: 10.1016/j.ypmed.2004.02.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Mammography screening can involve subsequent work-up to determine a final screening outcome. Understanding the likelihood of different events that follow initial screening is important if women and their health care providers are to be accurately informed about the screening process. METHODS We conducted an analysis of additional work-up following screening mammography to characterize use of supplemental imaging and recommendations for biopsy and/or surgical consultation and the factors associated with their use. We included all events following screening mammography performed between 1/1/1998 and 12/31/1999 on a population-based sample of 37,632 New Hampshire women. We calculated adjusted odds ratios (OR) and 95% confidence intervals (CI) for supplemental imaging and recommended biopsy and/or surgical consultation as function of age, menopausal status and HRT use, breast density, and family history of breast cancer. RESULTS Ninety-one percent of women (n = 34,445) did not require supplemental imaging. Among those who did (n = 3187), 84% had additional views, 9% ultrasound, and 7% received both. Supplemental imaging was affected by age (OR 0.84; 95% CI = 0.76-0.94 for 50-59; OR = 0.66; 95% CI = 0.58-0.75 for > or = 60 versus < 50), menopausal status, and HRT use (OR = 1.33; 95% CI = 1.21-1.47 for peri- or post-menopausal HRT users; OR = 1.14; 95% CI = 1.01-1.29 for premenopausal versus peri- or post-menopausal non-HRT users), breast density (OR = 1.43; 95% CI = 1.33-1.55 for dense versus fatty breasts) and family history (OR = 1.15; 95% CI = 1.06-1.25 for any versus none). In women with supplemental imaging, age (OR = 1.80; 95% CI = 1.11-2.90 for > or = 60, relative to <50) and imaging type (OR = 3.23; 95% CI = 2.38-4.38 for ultrasound with or without additional views versus additional views only) were significantly associated with biopsy and/or surgical consultation recommendation. In those with no supplemental imaging, breast density was associated with recommended biopsy and/or surgical consultation (OR = 1.53; 95% CI = 1.13-2.07 for dense versus fatty breasts). CONCLUSIONS Breast density and HRT use are both independent predictors of use of supplemental imaging in women. With advancing age (age 60 and older), women were less likely to require follow-up imaging but more likely to receive a recommendation for biopsy and/or surgical consultation. This information should be used to inform women about the likelihood of services received as part of the screening work-up.
Collapse
Affiliation(s)
- Patricia A Carney
- Department of Community and Family Medicine, Dartmouth Medical School, Hanover Lebanon, NH 03755, USA.
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Zackrisson S, Andersson I, Manjer J, Janzon L. Non-attendance in breast cancer screening is associated with unfavourable socio-economic circumstances and advanced carcinoma. Int J Cancer 2003; 108:754-60. [PMID: 14696103 DOI: 10.1002/ijc.11622] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Our first objective was to assess changes in non-attendance, proportion of advanced breast cancer and survival in Malmö Mammographic Service Screening Program, MMSSP, compared to a former trial, Malmö Mammographic Screening Trial, MMST. Our second objective was to describe non-attenders in MMSSP in socio-economic terms and risk for advanced breast cancer compared to attenders. Information from hospital and national registers was used to identify 33,800 women invited to service screening in MMSSP 1990-93. Attendance rates at first screening, the proportion of advanced breast cancers (Stage II-IV) and survival among non-attenders in MMSSP were compared to the non-attenders and with the control group of the former trial, MMST. Various socio-economic factors were assessed as potential predictors of non-attendance in MMSSP. Odds ratios (OR) and 95% confidence interval (CI) were computed. Incidence of breast cancer during a 10-year-period, relative risks and 95% CI among non-attenders compared to attenders in MMSSP were computed. Attendance rates were significantly lower in MMSSP but a lower proportion of advanced breast cancers and a somewhat better survival among breast cancer cases (not significant) was seen in non-attenders in MMSSP compared to MMST. In MMSSP non-attendance was associated with being unmarried, being born abroad, being not currently employed, crowded housing conditions and low income. Incidence of advanced breast cancer was significantly higher among non-attenders than among attenders. Attendance has decreased over time and potential reasons are discussed. Stage distribution and survival among non-attenders seem to have improved. Several socio-economic factors predict non-attendance and non-attenders are at higher risk for advanced breast cancer.
Collapse
Affiliation(s)
- Sophia Zackrisson
- Department of Community Medicine, Unit of Epidemiology, Lund University, Malmö University Hospital, Malmö, Sweden.
| | | | | | | |
Collapse
|