How recent changes to breast screening guidelines affect physician recommendations

Physicians have a wide range of opinions when it comes to when and how often to do breast cancer screening, according to a study published in JAMA Internal Medicine.

For the study, researchers set out to examine how recent changes to breast cancer guidelines may have affected physician recommendations.

They noted various professional societies and organizations are not on the same page when it comes to the optimal time to begin and discontinue breast cancer screening mammography and how often women should be screened.

For instance, the American Cancer Society changed its guidelines in October 2015, urging personalized screening decisions for women ages 40 to 44 and then annual screening for women ages 45 to 54, according to the study. Then last year the U.S. Preventive Services Task Force reissued its recommendations, urging personalized screening decisions for women ages 40 to 49 and biennial mammograms for women ages 50 to 74. Additionally, the American Congress of Obstetricians and Gynecologists recommends women age 40 and older get annual mammograms.

"With physician recommendations the most important determinant for patients obtaining screening, we investigated physician recommendations in light of recent guideline changes," the study's authors wrote.

Researchers specifically sent surveys to 2,000 physicians who were randomly selected from the American Medical Association Physician Masterfile from May to September of last year. Study participants reported providing primary care or general gynecologic care to women age 40 or older.

The study found overall that 81 percent of physicians recommended breast cancer screening for women ages 40 to 44, while 88 percent recommended breast cancer screening for women ages 45 to 49. Sixty-seven percent recommended breast cancer screening for women age 75 or older. Researchers said gynecologists were more likely than internal medicine and family medicine/general practice physicians to recommend breast cancer screening for women of all age groups.

Most physicians who recommend screening recommend it be done on an annual basis: nearly 63 percent for women ages 40 to 44 and nearly 67 percent for women ages 45 to 49, according to the study. The percentage dropped to 52.3 percent for women age 75 or older.

Additionally, 26 percent of physicians said they trusted ACOG guidelines most, compared with 23.8 percent for the ACS guidelines and 22.9 percent for the the USPSTF guidelines, the study found. Researchers said physicians who trusted ACS guidelines were 86.5 percent more likely to recommend breast cancer screening for women ages 40 to 44 and 94.7 percent more likely to recommend breast cancer screening for women ages 45 to 49 than physicians who trusted USPSTF guidelines. They said physicians who trusted ACOG guidelines were also way more likely to recommend breast cancer screening for those age groups than physicians who trusted USPSTF guidelines.

 

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