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Mammography Preferences Among Women in Their 40s
The U.S. Preventive Services Task Force (USPSTF) now recommends that all women begin screening mammography at age 40 (NEJM JW Gen Med Jun 1 2024 and JAMA 2024; 331:1918). Balancing the benefits and harms of mammography among younger patients is an ongoing challenge, not least because of individuals' varied perceptions of the those benefits and harms.
Researchers conducted a survey in 2022 to assess attitudes toward screening among a diverse group of 495 average-risk U.S. women (age, 39–49). Preference to initiate or delay mammography was determined before and after patients viewed a decision aid with information on mammography benefits and harms and completed a personal risk assessment.
Most participants indicated a preference to proceed with screening; however, 27% preferred to delay (either until older but before age 50 or until age 50) even before viewing the decision aid. This proportion increased significantly to 38% after viewing the decision aid. Participants who preferred to delay screening had lower breast cancer risk overall.
Comment
The new USPSTF guideline establishes a standard of care (screening for all women in their 40s), from which clinicians might be reluctant to deviate. However, these data suggest that engaging patients in individualized discussions about mammography — with or without a formal decision aid — still is valuable and might influence preferences. Many younger women are unsettled by conflicting and evolving mammography guidelines and would benefit from frank dialogue about the tradeoffs — a relatively small mortality benefit and a nontrivial incidence of false-positive results and overdiagnosed cancers.
Citation(s)
Author:
Scherer LD et al.
Title:
Mammography screening preferences among screening-eligible women in their 40s: A national U.S. survey.
Source:
Ann Intern Med
2024
Jul
16; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Sarah E. Post, MD