• Laura D Scherer, Carmen L Lewis, Kirsten McCaffery, Jolyn Hersch, Joseph N Cappella, Channing Tate, Brad Morse, Kelly Arnett, Bridget Mosley, Heather L Smyth, and Marilyn M Schapira.
• School of Medicine, University of Colorado, and Denver VA Center of Innovation, Aurora, Colorado (L.D.S.).
• Ann. Intern. Med. 2024 Aug 1; 177 (8): 106910771069-1077.

BackgroundThe U.S. Preventive Services Task Force (USPSTF) recently changed its recommendation for mammography screening from informed decision making to biennial screening for women aged 40 to 49 years. Although many women welcome this change, some may prefer not to be screened at age 40 years.ObjectiveTo conduct a national probability-based U.S. survey to investigate breast cancer screening preferences among women aged 39 to 49 years.DesignPre-post survey with a breast cancer screening decision aid (DA) intervention. (ClinicalTrials.gov: NCT05376241).SettingOnline national U.S. survey.Participants495 women aged 39 to 49 years without a history of breast cancer or a known BRCA1/2 gene mutation.InterventionA mammography screening DA providing information about screening benefits and harms and a personalized breast cancer risk estimate.MeasurementsScreening preferences (assessed before and after the DA), 10-year Gail model risk estimate, and whether the information was surprising and different from past messages.ResultsBefore viewing the DA, 27.0% of participants preferred to delay screening (vs. having mammography at their current age), compared with 38.5% after the DA. There was no increase in the number never wanting mammography (5.4% before the DA vs. 4.3% after the DA). Participants who preferred to delay screening had lower breast cancer risk than those who preferred not to delay. The information about overdiagnosis was surprising for 37.4% of participants versus 27.2% and 22.9% for information about false-positive results and screening benefits, respectively.LimitationRespondent preferences may have been influenced by the then-current USPSTF guideline.ConclusionThere are women in their 40s who would prefer to have mammography at an older age, especially after being informed of the benefits and harms of screening. Women who wanted to delay screening were at lower breast cancer risk than women who wanted screening at their current age. Many found information about the benefits and harms of mammography surprising.Primary Funding SourceNational Cancer Institute.

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