SUMMARY One hundred and thirty two women with normal breast screening results were interviewed six months after their attendance at the Edinburgh Breast Screening Clinic. Eight percent of women said screening had made them more anxious about developing breast cancer. Thirty eight percent said they were more aware of the disease since screening but they regarded this as advantageous. Seventy percent of the women were still practising breast self-examination. There was no difference in the psychiatric morbidity of the screened sample when compared with a matched random sample community control group. Neither was there any difference in the General Health Questionnaire case rates before and after screening. Screening does not appear to increase the prevalence of psychiatric morbidity. Twenty nine percent of the interview sample were examining their breasts more than once a month-21% once a week or more. However, these frequent self-examiners did not have a greater prevalence of psychiatric morbidity than their matched controls.
In a study of why a sample of women, aged 45-64 and registered with a group practice in Edinburgh, attended or did not attend the Edinburgh Breast Screening Clinic demographic, aetiological, social, and perceptual characteristics of attendees and non-attenders were compared. Similar proportions of attendees and non-attenders knew the chance of a breast lump being cancer and were aware of the benefits of early diagnosis and treatment. The study, however, suggests that non-attenders saw the screening clinic as a place of risk while the attendees saw screening in a positive light: 79% of non-attenders as compared with 36% of attendees said that they were afraid of cancer being found, and most women attended either to reassure themselves that they had not got breast cancer or to receive early treatment if they had. Furthermore, 72% of non-attenders as compared with 13% of attendees were anxious that their lives would be disrupted if cancer were found at the screening clinic. There may well be an important irreducible element to non-atten-
As part of the evaluation of a health education campaign about breast disease, consultations for breast problems were monitored in five general practices over an 18-month period in Edinburgh. No increase was found as a result of the campaign, nor was there any increase in the number of biopsies performed. On average, each GP saw 13 women with breast problems each year, a rate of 1.6 per cent; 29 per cent were referred to hospital, regardless of their age. The most common presenting symptom was pain (47 per cent), with 35 per cent complaining of a lump. The reasons for hospital referral are discussed. It is suggested that GPs may refer too many young women to a specialist clinic, although this may be inevitable.
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