U.S. women's perceived importance of the harms and benefits of mammograms and associations with screening ambivalence: Results from a national survey

The American Cancer Society and the U.S. Preventive Task Force recently recommended that women initiate routine breast cancer screening at older ages (45 and 50, respectively) than previously recommended, and both organizations emphasize the importance of weighing the harms of mammograms against the benefits in making informed decisions. However, little is known from national samples about how women perceive the harms and benefits of mammograms, and how these perceptions relate to their attitudes about getting mammograms. To fill this gap, we surveyed a nationally representative sample of 557 U.S. women aged 30–59 about their perceptions of harms and benefits and their attitudinal ambivalence toward mammograms. We found that respondents overall perceived the benefits as more important than harms, but those who were aware of recent recommendations perceived mammogram harms as more important than those who were unaware. Women who had a mammogram within one year perceived the harms as less important and the benefits as more important, compared to those who had not had a mammogram in the past year. Those who perceived the harms as important were more ambivalent about screening than those who perceived harms as less important. We conclude that if the public health goal is to prevent the population harms from overuse of mammograms (e.g., overdiagnosis, false positives), simply providing women with information about harms and benefits may not lead to this outcome, since women are likely to perceive the benefits as more important than harms, and thus make an informed choice to obtain screening.