Abstract
Background: The utility of mammography screening as an efficacious tool for early detection is being contested due to the risk of potential harms including false positives and over-diagnosis. Yet there is little research regarding women's experiences, values or preferences for participating in mammography programs. Our aim was to explore women's actual experiences of a false positive mammography screen and their perceptions of the value, risks and benefits given their recent experience among a diverse group of mammography screeners.
Methods: Semi-structured interviews were completed with 40 women who experienced a recent false positive mammogram at an academic hospital that provides care to low-income, medically underserved women. Interviews were recorded and transcribed verbatim. A directed content analysis was used to identify and explore primary themes. Knowledge of breast cancer risk was also assessed.
Findings: Unlike most cancer screening samples, women in our study were quite diverse; 45% were African American, 27% were uninsured or insured through Medicare/Medicaid and 22.5% reported incomes less than $30,000. Receiving a false positive mammography screen generated worry among 60% (n=24) of women. Yet 70% maintained that mammography screening was necessary despite the worry incurred. Women also described the experience as stimulating greater interest in additional cancer prevention activities (32.5%; n=13) and one third discussed needing more information about the risks and benefits of mammography screening. Less than one quarter of women (22.5%; n=9) correctly identified a women's lifetime risk of developing breast cancer, 20% (n=8) overestimated and 57.5% (n=23) underestimated this risk.
Conclusion: Our findings represent the experiences of a diverse sample of women whose voices are typically underrepresented and often excluded from the ongoing and contentious medical dialogue regarding mammography. Women reported needing more information about the risks and benefits of mammography screening but also considered false positives an acceptable risk. It is clear that women require and are demanding, more information regarding breast cancer prevention in general and mammography screening in particular. Further, our results suggest that breast cancer screening programs may provide a unique opportunity to deliver additional breast cancer prevention interventions.
Citation Format: Maria D. Thomson. Included in the debate: Women's perspectives on mammography after experiencing a false positive screen. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A07.