The public's response to the U.S. Preventive Services Task Force's 2009 recommendations on mammography screening

Abstract

Background: On November 16, 2009, the U.S. Preventive Services Task Force (USPSTF) released new breast cancer screening recommendations, resulting in considerable controversy.

Purpose: The purpose of this investigation was to assess the volume and framing of the public discourse around the mammography recommendations and determine if women were knowledgeable about the new recommendations.

Methods: Two different types of data collection methods were used for this study: (1) a content analysis of news stories and social media posts around the time of the USPSTF announcement and (2) a web-based survey of women aged 40-74 years conducted through Knowledge Networks from December 17, 2009, to January 6, 2010. Data were analyzed in 2010.

Results: The survey sample included 1221 women aged 40-74 years who had never had breast cancer. The majority of the articles and posts (51.9%) did not support the screening recommendations, and 17.6% were supportive. Less than one quarter of the sample could identify the new recommendations for women aged 40-49 years and 50-74 years. Results from logistic regression analyses identified characteristics associated with correct knowledge of the recommendations for each age group. Level of attention paid to the recommendations was significantly associated with accurate knowledge of the recommendations for each age group. Having a mammogram within the past 2 years, "other" race (i.e., not black or white), and having higher levels of education, confidence that recommendations were based on the latest research, and attention paid to the new guidelines were all significantly and positively associated with correct knowledge of the new recommendation for women aged 40-49 years.

Conclusions: The new recommendations confused women (30.0%) more than they helped them understand when to get a mammogram (6.2%). Confusion was greatest among women aged 40-49 years and women who had never had a mammogram or who had one more than 2 years ago. Communication about future recommendations should be pretested to identify strategies and language that may reduce confusion among providers, consumers, and advocacy groups.