Does mammographic screening and a negative result affect attitudes towards future breast screening?

Abstract

Objectives-To investigate the impact of an experience of a benign mammographic result on intention to seek medical help immediately in the case of breast abnormalities, and on intentions and thoughts about future participation in screening. Setting-The Dutch Breast Cancer Screening Programme for women aged 50-69. Methods-Subjects were women who were invited for an initial breast examination: 223 women filled out a questionnaire about 10 days before and about 6 weeks after their initial breast examination. To be able to control for possible test eVects, another group of 293 women filled out a questionnaire only after mammography. Changes in thoughts and intentions were examined. Results-Most women were very satisfied with the course of their initial breast examination, although pain or discomfort was often mentioned. No clues to suggest false reassurance were found: more than 99% of the women would consider the possibility of breast cancer if they felt a lump in one of their breasts. In such a situation, most women intended to seek medical help within a week. These variables were not influenced by the experience of mammography with a benign result. In general, women were very positive about (repeat) participation, both before and after screening. After screening, the average woman perceived fewer costs in participating, and perceived her own ability to engage in future screening as higher. However, the experience of pain and anxiety during the initial screening did lead to reverse eVects. Women who were less satisfied about their treatment by the staV were more likely to change their intentions to reparticipate in a negative way. Conclusions-As, in general, women became more positive about regular participation after they had attended breast cancer screening, eVorts to improve first round attendance must be continued. At the same time, the screening organisations must continue to prioritise the high level of client friendliness throughout the screening. No evidence for detrimental eVects of screening through false reassurance among participants was found. (J Med Screen 2001;8:204-212)

Increasing participant recruitment into large-scale screening trials: experience from the CADET II study

“…The concept of CAD and the need for a trial in the screening programme are difficult to explain in lay terms within the confines of a participant information sheet so it is perhaps not surprising that even a simplified information sheet may have had little impact. This may indicate that women were not reading the information sheet 20 or that they had difficulty understanding the original and the simplified version. 24 In Coventry and Manchester, all women recruited into the study attended mobile screening units, an environment that is not ideal for recruitment due to logistical limitations of space, time and available staff.…”

Evidence for U.S. Preventive Services Task Force (USPSTF) Recommendations Against Routine Mammography for Females between 40-49 Years of Age

“…There are only few studies that evaluated the effect of negative mammography results (Drossaert et al, 2001). False-negative mammography results occur least among females 40-49 years old (1.0 per 1000 females per screening round) (Drossaert et al, 2001).…”

“…False-negative mammography results occur least among females 40-49 years old (1.0 per 1000 females per screening round) (Drossaert et al, 2001). However, additional studies seem necessary to understand the rate and burden of false-negative mammography findings in these females.…”

The impact of screening on future health-promoting behaviours and health beliefs: a systematic review

“…Of these studies, three used a prospective design, [222][223][224] with two of them also collecting baseline measures (prescreening). 222,224 The studies that investigated the effects of screening on future outcomes reported that receiving a false-positive result increased perception of susceptibility to breast cancer and led to increased GP visits, 222 and that reattendance rates at the next routine breast screening appointment were lower in the women with false-positive results than in women who received a normal result.…”

“…222,224 The studies that investigated the effects of screening on future outcomes reported that receiving a false-positive result increased perception of susceptibility to breast cancer and led to increased GP visits, 222 and that reattendance rates at the next routine breast screening appointment were lower in the women with false-positive results than in women who received a normal result. 223 Reattendance at the next routine breast screening appointment was investigated in a further two papers, both focusing on women who received false-positive results.…”