Breast Cancer Screening: What MDs Recommend

In a U.S.-wide study examining breast cancer screening recommendations physicians give their patients, results show that annual examinations are often recommended by clinicians. The study, published in JAMA Internal Medicine, was conducted amid recent guideline changes.

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Guidelines issued by various professional societies and organisations differ about the best time to start and to discontinue mammography for breast cancer screening, as well as the optimal amount of time between screenings. For example, the American Cancer Society (ACS) revised its guidelines in 2015 to encourage personalised screening decisions for women 40 to 44 followed by annual screening starting at age 45 and biennial screening for women 55 or older.

In 2016, the U.S. Preventive Services Task Force (USPSTF) reissued its recommendations on personalised screening decisions for women 40 to 49 followed by biennial mammograms for women 50 to 74. Meanwhile, the American Congress of Obstetricians and Gynecologists (ACOG) recommends yearly mammograms for women 40 and older.

Archana Radhakrishnan, MD, MHS, of Johns Hopkins University, Baltimore, Md., and colleagues examined physician screening recommendations in a national sample of physicians – 52 percent response rate (871 of 1,665 physicians). Most of the physicians were family medicine/general practice physicians (44.2 percent), almost 30 percent were internal medicine physicians and 26.1 percent were gynaecologists.

Among the physicians who participated in the study, 26 percent reported trusting ACOG guidelines the most; 23.8 percent the ACS guidelines and 22.9 percent the USPSTF guidelines. Other key findings of the study include:

• 81 percent of physicians recommended screening to women 40 to 44; 88 percent to women 45 to 49; and 67 percent for women 75 or older.
• Gynaecologists were more likely to recommend screening for women of all ages compared with internal medicine and family medicine/general practice physicians.
• Among clinicians who recommend screening, most recommend annual examinations.

“The results provide an important benchmark as guidelines continue evolving and underscore the need to delineate barriers and facilitators to implementing guidelines in clinical practice,” the authors conclude.

Source: JAMA Internal Medicine
Image Credit: Wikimedia Commons