222665 U.S. primary care physicians' breast cancer screening beliefs and practices

Monday, November 8, 2010 : 4:50 PM - 5:10 PM

Helen I. Meissner, PhD , Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD
Carrie Klabunde, PhD , Applied Research Program, National Cancer Institute, Bethesda, MD
Paul Han, MD, MPH , Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME
Vicki Benard, PhD , Division of Cancer Prevention and Control, CDC, Atlanta, GA
Nancy Breen, PhD , Applied Research Program, National Cancer Institute, Bethesda, MD
For close to two decades, scientific experts have disagreed about the age at when to start and stop breast cancer screening, the schedule on which tests should occur and the effectiveness of different screening modalities. Despite these controversies, most experts agree that screening has been effective in reducing breast cancer mortality.

While much is known about factors influencing women to get screened, little information is available about physicians' current breast cancer screening practices. This study explores the characteristics of four types of primary care physicians (family practice, general medicine, internal medicine and obstetrics/gynecology) and how their beliefs and practices are associated with breast cancer screening using the National Survey of Primary Care Physicians' Recommendations and Practice for Breast, Cervical, Colorectal and Lung Cancer Screening. The survey, fielded September 2006-May 2007, included questions about physician and practice characteristics and recommendations for breast cancer screening for women ages 40-49 and 50 and older. Physicians also were queried about their beliefs regarding clinical guidelines, test effectiveness and barriers to screening.

In our sample of primary care physicians (N=1212), virtually all report routinely recommending mammography, clinical breast exam and breast self exam to their patients. For those who recommend tests, there was variation in factors associated with recommending an age at which to discontinue screening. These include physician specialty, gender, international medical training and perceptions of which breast cancer screening guidelines are influential.

These results serve as an important baseline to monitor the impact of changes in age-specific clinical guidelines on physician screening practices.

Learning Areas:
Chronic disease management and prevention
Clinical medicine applied in public health
Provision of health care to the public

Learning Objectives:
1. Identify sociodemographic, health system and practice characteristics associated with primary physician recommendations for breast cancer screening. 2. Describe primary care physician beliefs about breast cancer screening test effectiveness. 3. Explain physician barriers to breast cancer screening. 4. Discuss the implications of physician current

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conduct research in the area of physician cancer screening behaviors
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.