Mammography screening of women in their 40s: impact of changes in screening guidelines

Abstract

Background: : In March 1997, the American Cancer Society (ACS) updated its recommended mammography screening interval for women ages 40-49 years from once every 1 to 2 years to once every year. At the same time, the National Cancer Institute (NCI), which had previously not recommended routine screening of women in their 40s, began recommending screening at 1 to 2-year intervals. These events occurred during the data collection phase of a prospective study of mammography screening and, thereby, provided an unexpected opportunity to examine the potential influences of changing guidelines on women's beliefs about how frequently they should obtain screening exams.

Methods: : This analysis included 1451 African American and white women ages 40-79 years, who obtained an "index" screening exam between October 1996 and January 1998. In baseline and 2-year follow-up telephone interviews, respondents provided information on demographic, socioeconomic, health history, medical care, behavioral and psychosocial factors, and on how frequently they believed women of their age should obtain screening mammograms.

Results: : After the ACS and NCI announcements of new screening guidelines for women in their 40s, a significant increase in endorsement of annual screening among women ages 40-49 years was observed, consistent with the ACS recommendation for annual screening in that age group. No increase in endorsement of annual screening among women ages 50 years and older was evident during the same time period.

Conclusions: : Women's beliefs about how frequently they should obtain mammography screenings appear to change in response to changes in recommendations of high-profile health organizations, particularly when those recommendations call for an increase in screening.