Physician Adherence to U.S. Preventive Services Task Force Mammography Guidelines

• Published in: Women's health issues Vol. 24; no. 3; pp. e313 - e319
• Main Authors: Corbelli, Jennifer, MD, MS, Borrero, Sonya, MD, MS, Bonnema, Rachel, MD, MS, McNamara, Megan, MD, MS, Kraemer, Kevin, MD, MS, Rubio, Doris, PhD, Karpov, Irina, MS, McNeil, Melissa, MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2014
• Subjects: Adult; Aged; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - prevention & control; Cross-Sectional Studies; Doctors; Early Detection of Cancer; Female; Guideline Adherence - statistics & numerical data; Health Surveys; Humans; Logistic Models; Male; Mammography; Mammography - standards; Mass Screening - standards; Middle Aged; Obstetrics and Gynecology; Practice Guidelines as Topic; Practice Patterns, Physicians' - statistics & numerical data; Preventive health care; Primary Health Care - organization & administration; Screening; Task forces; United States
• DOI: 10.1016/j.whi.2014.03.003
• ISSN: 1049-3867

Abstract Background In 2009, the U.S. Preventive Services Task Force (USPSTF) guidelines for screening mammography changed significantly, and are now in direct conflict with screening guidelines of other major national organizations. The extent to which physicians in different primary care specialties adhere to current USPSTF guidelines is unknown. Methods We conducted a cross-sectional web-based survey completed by 316 physicians in internal medicine, family medicine (FM), and gynecology (GYN) from February to April 2012. Survey items assessed respondents' breast cancer screening recommendations in women of different ages at average risk for breast cancer. We used descriptive statistics to generate response distribution for survey items, and logistic regression models to compare responses among specialties. Findings The response rate was 55.0% (316/575). A majority of providers in internal medicine (65%), FM (64%), and GYN (92%) recommended breast cancer screening starting at age 40 versus 50. A majority of providers in internal medicine (77%), FM (74%), and GYN (98%) recommended annual versus biennial screening. Gynecologists were significantly more likely than both internists and family physicians to recommend initial mammography at age 40 ( p ≤ .0001) and yearly mammography ( p  = .0003). There were no other differences by respondent demographic. Conclusions Primary care providers, especially gynecologists, have not implemented USPSTF guidelines. The extent to which these findings may be driven by patient versus provider preferences should be explored. These findings suggest that patients are likely to receive conflicting breast cancer screening recommendations from different providers.