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Women lack education on harms, benefits of breast cancer screening

Women are more likely to know of the benefits of mammography screening, but are not aware of the potential harms, indicating that they lack balanced information from physicians and public health officials that often only emphasize the benefits of breast cancer screening, according to findings published in JAMA Internal Medicine.

“It is not well known how women in the general U.S. public perceive the benefits and harms of mammography screening,” Jiani Yu, BA, from the division of health policy and management at University of Minnesota School of Public Health, and colleagues wrote. “Previous research has been published on public enthusiasm for screening and underestimates of harms, but these findings may be outdated.”

Researchers examined data from 407 U.S. women aged 40 to 59 years recruited by a survey research firm to determine their awareness and perceptions of the benefits and harms of mammography. The women randomly received a stand-alone module about awareness of the benefits/harms of mammograms and assessments of the importance of these benefits/harms. Prior to receiving these modules, they answered questions about their general and mammogram-related news and health media consumption. To determine their mammogram history, the investigators also asked whether the participant had ever had a mammogram and when they had their most recent mammogram to check for breast cancer.

In total, 14.2% of participants reported never having a mammogram, 56.4% reported having a mammogram within the past year and 29.4% reported having a mammogram more than a year ago. More than 90% of participants were aware that mammography can benefit women by saving lives, leading to earlier treatment of breast cancer, finding that you don’t have breast cancer and sometimes finding cancer before symptoms begin. Of these women, 54.8% considered each benefit as very important when asked to rate their significance. In contrast, only 26.5% of participants reported previous awareness of overdiagnosis and 39.7% of overtreatment, but 74.9% knew of false-positive results and the possible of psychological distress.

Fewer women considered the harms of mammogram to be significant, with only 15.1% reporting health care costs and 28.7% reporting overtreatment as very important. Notably, women who had a mammogram within the past year were more likely to rate all benefits as very important compared with those who never had a mammogram (62.4% to 74.9% vs. 44.9% to 58%; P < .05).

“Our findings suggest that there are opportunities for targeted education and communication at both the general public and individual levels, with a focus on educating women on the harms of screening, which they are much more likely to experience than benefits,” Yu and colleagues wrote. “However, the fact that women are predisposed to consider benefits as more important than harms poses a challenge to informed decision making about screening, suggesting the need for new paradigms in communicating the cumulative risks of the benefits and harms.” – by Savannah Demko

Disclosures: The researchers report no relevant financial disclosures.