Epoch HealthWhen More Informed, 20 Percent of Women in Their 40s Want to Delay Mammograms

Informed Decision-Making in Breast Cancer Screening: Balancing Benefits and Risks

A recent study published in the Annals of Internal Medicine reveals that when presented with comprehensive information about mammography benefits and risks, approximately 20% of women in their 40s choose to delay breast cancer screening until age 50. The research, conducted by the University of Colorado, highlights the impact of informed consent on screening decisions while stressing the importance of personalized risk assessment in breast cancer prevention strategies.

Key Points:

• The study surveyed nearly 500 women aged 39 to 49 about their mammography preferences.
• Participants were provided with a decision aid detailing mammography benefits and potential harms.
• After reviewing the decision aid, 18% of women opted to delay mammograms until age 50, up from 8% before the information was provided.
• Women who chose to delay screening were typically at low risk for breast cancer.
• Concerns about overdiagnosis and lack of family history were common reasons for delaying screening.
• The decision aid revealed that out of 1,000 women screened between ages 40-49, 239 experienced a false positive result.
• Starting screening at age 40 was reported to save one additional life per 1,000 women screened.
• 57.2% of surveyed women still preferred to have a mammogram after reviewing the decision aid.
• 37% of participants expressed surprise at the statistics on overdiagnosis.
• The study was conducted between 2009 and 2022, prior to the US Preventive Services Task Force’s 2024 guideline change.
• In April 2024, USPSTF updated recommendations to advise biennial breast cancer screenings for all women starting at age 40.

HCN Medical Memo
This study emphasizes the importance of personalized risk assessment and informed decision-making in breast cancer screening. As healthcare providers, it’s crucial to engage patients in discussions about the benefits and potential harms of mammography, tailoring recommendations based on individual risk factors and preferences.

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