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Open Access Research article

Women’s responses to changes in U.S. preventive task force’s mammography screening guidelines: results of focus groups with ethnically diverse women

Jennifer D Allen12*, Shirley Morrison Bluethmann3, Margaret Sheets1, Kelly Morrison Opdyke4, Kathryn Gates-Ferris4, Marc Hurlbert5 and Elizabeth Harden1

Author Affiliations

1 Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA

2 Harvard Medical School, Boston, USA

3 University of Texas School of Public Health, Houston, USA

4 Cicatelli Associates Inc. (CAI), New York, USA

5 Avon Foundation for Women, New York, USA

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BMC Public Health 2013, 13:1169  doi:10.1186/1471-2458-13-1169

Published: 12 December 2013

Abstract

Background

The 2009 U.S. Preventive Services Task Force (USPSTF) changed mammography guidelines to recommend routine biennial screening starting at age 50. This study describes women’s awareness of, attitudes toward, and intention to comply with these new guidelines.

Methods

Women ages 40–50 years old were recruited from the Boston area to participate in focus groups (k = 8; n = 77). Groups were segmented by race/ethnicity (Caucasian = 39%; African American = 35%; Latina = 26%), audio-taped, and transcribed. Thematic content analysis was used.

Results

Participants were largely unaware of the revised guidelines and suspicious that it was a cost-savings measure by insurers and/or providers. Most did not intend to comply with the change, viewing screening as obligatory. Few felt prepared to participate in shared decision-making or advocate for their preferences with respect to screening.

Conclusions

Communication about the rationale for mammography guideline changes has left many women unconvinced about potential disadvantages or limitations of screening. Since further guideline changes are likely to occur with advances in technology and science, it is important to help women become informed consumers of health information and active participants in shared decision-making with providers. Additional research is needed to determine the impact of the USPSTF change on women’s screening behaviors and on breast cancer outcomes.

Keywords:
Mammography; Screening guidelines; Health communication