• Ashley J Housten, Diana S Hoover, Maggie Britton, Therese B Bevers, Richard L Street, Lorna H McNeill, Larkin L Strong, Jolyn Hersch, Kirsten McCaffery, and Robert J Volk.
• Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. ahousten@wustl.edu.
• J Gen Intern Med. 2022 Apr 1; 37 (5): 114511541145-1154.

BackgroundConflicting breast cancer screening recommendations have the potential to diminish informed decision making about screening.ObjectiveWe examined the knowledge, attitudes, and intentions related to divergent recommendations for breast cancer screening among racially/ethnically diverse women.DesignWe used a multimethod study design employing focus groups and questionnaires. Focus groups included: (1) two 10-min presentations on the national screening recommendations and the potential benefits and harms of screening and (2) an interactive discussion. Data were collected: 8/3/2017 to 11/19/2019. Analysis occurred from 1/21/2019 to 7/24/2020.ParticipantsParticipants were (1) women 40-75 years; (2) English or Spanish speaking; (3)self-identified as Latina, Black, or non-Latina White; and (4) no known increased risk for breast cancer.Main MeasuresMain outcomes were participants' knowledge and perceptions of benefits and harms of screening mammography and their screening intentions. Focus groups were transcribed and analyzed using a qualitative descriptive approach. Quantitative data were summarized using descriptive statistics.Key ResultsOne hundred thirty-four women (n=52, 40-49 years; n=82, 50-75 years) participated in 28 focus groups. Participants were Latina (n=44); Black (n=51); and non-Latina White (n=39). Approximately one-quarter (n=32) had limited health literacy and almost one-fifth (n=23) had limited numeracy. In the context of differing national screening recommendations, participants questioned the motives of the recommendation-making agencies, including the role of costs and how costs were considered when making screening recommendations. Participants expressed concern that they were not represented (e.g., race/ethnicity) in the data informing the recommendations. Immediately following the focus groups, most participants expressed intention to screen within the upcoming year (pre n=100 vs. post n=107).ConclusionsDivergent breast cancer screening recommendations may lead to mistrust and paradoxically reinforce high overall enthusiasm for screening.© 2022. The Author(s) under exclusive licence to Society of General Internal Medicine.

25 keywords...

hide…