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Research ArticleOriginal Article

Conflicting National Recommendations and the Use of Screening Mammography: Does the Physician's Recommendation Matter?

Stephen H. Taplin, Nicole Urban, Victoria M. Taylor and Jim Savarino
The Journal of the American Board of Family Practice March 1997, 10 (2) 88-95; DOI: https://doi.org/10.3122/jabfm.10.2.88
Stephen H. Taplin
From the Group Health Cooperative of Puget Sound (SHT, JS), the University of Washington (SHT, NU, VMT), and Fred Hutchinson Cancer Research Center (SHT, NU, VMT), Seattle. Address reprint requests to Stephen H. Taplin, MD, MPH, Group Health Cooperative of Puget Sound, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1448
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Nicole Urban
From the Group Health Cooperative of Puget Sound (SHT, JS), the University of Washington (SHT, NU, VMT), and Fred Hutchinson Cancer Research Center (SHT, NU, VMT), Seattle. Address reprint requests to Stephen H. Taplin, MD, MPH, Group Health Cooperative of Puget Sound, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1448
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Victoria M. Taylor
From the Group Health Cooperative of Puget Sound (SHT, JS), the University of Washington (SHT, NU, VMT), and Fred Hutchinson Cancer Research Center (SHT, NU, VMT), Seattle. Address reprint requests to Stephen H. Taplin, MD, MPH, Group Health Cooperative of Puget Sound, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1448
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Jim Savarino
From the Group Health Cooperative of Puget Sound (SHT, JS), the University of Washington (SHT, NU, VMT), and Fred Hutchinson Cancer Research Center (SHT, NU, VMT), Seattle. Address reprint requests to Stephen H. Taplin, MD, MPH, Group Health Cooperative of Puget Sound, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1448
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Abstract

Background: This study evaluated whether women's perceptions of the conflicting recommendations for breast cancer screening were associated with decreased use of mammography.

Methods: We conducted a random-digit-dial telephone survey of 1024 women in four communities of western Washington State. In addition to collecting data for demographics, beliefs about mammography, and insurance coverage, we inquired whether the respondents were aware of any conflicting recommendations about when to begin or how frequently to perform screening mammography, whether their physicians had recommended a mammogram, and whether they were likely to do what their physicians recommended. After grouping women according to whether they perceived conflicting recommendations, we used chi-square statistics to compare the distribution of proportions of women by age, race, household income, education, and insurance coverage. To estimate the odds of their having a mammogram in the previous 2 years (yes or no), we used multivariate logistic regression and included the above variables as covariates.

Results: Sixty-two percent of eligible women completed the survey, and 49 percent (479 of 985) perceived conflicting recommendations. The association between perceiving conflict and mammography use was not significant. Eighty-three percent of women who perceived conflicting recommendations reported being more comfortable using their own judgment about getting the procedure. After controlling for whether women perceived conflicting recommendations and all other factors, women who said they followed their physician's advice but did not recall their physician recommending mammography were 71 percent less likely to have received a recent mammogram than were women who reported their physician did recommend it (odds ratio 0.29, confidence interval 0.16-0.51).

Conclusions: The conflicting recommendations surrounding breast cancer screening are not influencing women's choices about mammography. The physician recommendation and women's self-reported likeliness to follow it are the most important factors associated with mammography use.

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The Journal of the American Board of Family     Practice: 10 (2)
The Journal of the American Board of Family Practice
Vol. 10, Issue 2
1 Mar 1997
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Conflicting National Recommendations and the Use of Screening Mammography: Does the Physician's Recommendation Matter?
Stephen H. Taplin, Nicole Urban, Victoria M. Taylor, Jim Savarino
The Journal of the American Board of Family Practice Mar 1997, 10 (2) 88-95; DOI: 10.3122/jabfm.10.2.88

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Conflicting National Recommendations and the Use of Screening Mammography: Does the Physician's Recommendation Matter?
Stephen H. Taplin, Nicole Urban, Victoria M. Taylor, Jim Savarino
The Journal of the American Board of Family Practice Mar 1997, 10 (2) 88-95; DOI: 10.3122/jabfm.10.2.88
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