Women in their 40s may choose to delay breast cancer screening if they’re informed about the benefits and harms, according to a US survey of 495 women aged between 39 and 49 who had no history of breast cancer or a known BRCA1/2 gene mutation that increases breast cancer risk. Potential harms explained to the women included breast cancer overdiagnosis and the risk of receiving a false positive result. Before the women were informed, 8.5% of them said they’d wait until 50 for a screen, and afterwards, 18% decided to wait. Importantly, none of the women said they’d been put off screening altogether after being informed about the potential harms.
Journal/conference: Annals of Internal Medicine
Link to research (DOI): 10.7326/M23-3325
Organisation/s: The University of Sydney, University of Colorado, USA
Media release
From: American College of Physicians
Survey finds women in their 40s may choose to delay mammography when informed about the benefits and harmsA nationally representative U.S. survey found women in their 40s may decide to start mammography at an older age when informed about the benefits and potential harms of breast cancer screening, including overdiagnosis and the risk for a false positive result. Women who wanted to delay screening after being presented with a decision aid describing the evidence were at a lower breast cancer risk than those who wanted screening at their current age. These findings are particularly relevant as the U.S. Preventive Services Task Force (USPSTF) recently changed its recommendation for mammography screening from informed decision making to biennial screening for women aged 40 to 49 years. The study is published in Annals of Internal Medicine.Researchers from the University of Colorado School of Medicine, Denver VA Center of Innovation surveyed 495 women aged 39 to 49 years without a history of breast cancer or a known BRCA1/2 gene mutation to assess screening preferences before and after receipt of a decision aid describing the benefits and harms of beginning screening at age 40. The researchers found that before the decision aid, 8.5% of participants preferred to wait until 50 to screen versus 18% after reading the decision aid. There was no increase in the number of participants who said they never wanted to have mammograms, suggesting that the evidence did not discourage screening altogether. Persons with higher breast cancer risk preferred earlier screening. More than a quarter of participants indicated that overdiagnosis was different than what their doctor told them and almost one-third found that information about overdiagnosis conflicted with other messaging about screening. These findings suggest that providing information about both benefits and harms may change intention to screen for some women.An accompanying editorial from the University of Toronto touches on the importance of informed decision making with regard to breast cancer screening, as well as equitable access to care.
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