Abstract
Background: Scientists, clinicians, and other experts aim to maximize the benefits of cancer screening while minimizing its harms. Chief among these harms are overdiagnosis and overtreatment. Although available data suggest that patient awareness of these harms is low, we know little about how patients respond to information about these phenomena. Objectives: Using the case of breast cancer screening, this study assesses women's awareness of and reactions to statements about overdiagnosis and overtreatment. Methods: We draw on data from a 2016 population-based survey of US women aged 35-55 years that oversampled women of lower socioeconomic position (those living at or below 100% of federal poverty level) (N=429). Results: Results showed that women's awareness of overdiagnosis (16.5%) and overtreatment (18.0%) was low, and women under age 40 were least likely to have heard about overdiagnosis. Most women did not evaluate statements about these harms positively: <1 in 4 agreed with and found statements about overdiagnosis and overtreatment to be believable, and even fewer evaluated them as strong arguments to consider in their own mammography decision making. Women with a recent mammogram history were particularly unconvinced by overdiagnosis and overtreatment arguments. Conclusions: A majority of women were unaware of 2 important harms of breast cancer screening: overdiagnosis and overtreatment. Most did not find statements about these harms to be believable and persuasive. Communication interventions, supported by evidence from health communication research, are necessary to improve patient understanding of screening's harms, promote informed decision making, and, in turn, ensure high-value care.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 879-885 |
| Number of pages | 7 |
| Journal | Medical care |
| Volume | 55 |
| Issue number | 10 |
| DOIs | |
| State | Published - Jan 1 2017 |
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Keywords
- breast cancer
- health communication
- mammography screening
- overdiagnosis
- overtreatment
Cite this
Women's Awareness of and Responses to Messages about Breast Cancer Overdiagnosis and Overtreatment. / Nagler, Rebekah H.; Franklin Fowler, Erika; Gollust, Sarah E.
In: Medical care, Vol. 55, No. 10, 01.01.2017, p. 879-885.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Women's Awareness of and Responses to Messages about Breast Cancer Overdiagnosis and Overtreatment
AU - Nagler, Rebekah H.
AU - Franklin Fowler, Erika
AU - Gollust, Sarah E.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: Scientists, clinicians, and other experts aim to maximize the benefits of cancer screening while minimizing its harms. Chief among these harms are overdiagnosis and overtreatment. Although available data suggest that patient awareness of these harms is low, we know little about how patients respond to information about these phenomena. Objectives: Using the case of breast cancer screening, this study assesses women's awareness of and reactions to statements about overdiagnosis and overtreatment. Methods: We draw on data from a 2016 population-based survey of US women aged 35-55 years that oversampled women of lower socioeconomic position (those living at or below 100% of federal poverty level) (N=429). Results: Results showed that women's awareness of overdiagnosis (16.5%) and overtreatment (18.0%) was low, and women under age 40 were least likely to have heard about overdiagnosis. Most women did not evaluate statements about these harms positively: <1 in 4 agreed with and found statements about overdiagnosis and overtreatment to be believable, and even fewer evaluated them as strong arguments to consider in their own mammography decision making. Women with a recent mammogram history were particularly unconvinced by overdiagnosis and overtreatment arguments. Conclusions: A majority of women were unaware of 2 important harms of breast cancer screening: overdiagnosis and overtreatment. Most did not find statements about these harms to be believable and persuasive. Communication interventions, supported by evidence from health communication research, are necessary to improve patient understanding of screening's harms, promote informed decision making, and, in turn, ensure high-value care.
AB - Background: Scientists, clinicians, and other experts aim to maximize the benefits of cancer screening while minimizing its harms. Chief among these harms are overdiagnosis and overtreatment. Although available data suggest that patient awareness of these harms is low, we know little about how patients respond to information about these phenomena. Objectives: Using the case of breast cancer screening, this study assesses women's awareness of and reactions to statements about overdiagnosis and overtreatment. Methods: We draw on data from a 2016 population-based survey of US women aged 35-55 years that oversampled women of lower socioeconomic position (those living at or below 100% of federal poverty level) (N=429). Results: Results showed that women's awareness of overdiagnosis (16.5%) and overtreatment (18.0%) was low, and women under age 40 were least likely to have heard about overdiagnosis. Most women did not evaluate statements about these harms positively: <1 in 4 agreed with and found statements about overdiagnosis and overtreatment to be believable, and even fewer evaluated them as strong arguments to consider in their own mammography decision making. Women with a recent mammogram history were particularly unconvinced by overdiagnosis and overtreatment arguments. Conclusions: A majority of women were unaware of 2 important harms of breast cancer screening: overdiagnosis and overtreatment. Most did not find statements about these harms to be believable and persuasive. Communication interventions, supported by evidence from health communication research, are necessary to improve patient understanding of screening's harms, promote informed decision making, and, in turn, ensure high-value care.
KW - breast cancer
KW - health communication
KW - mammography screening
KW - overdiagnosis
KW - overtreatment
UR - http://www.scopus.com/inward/record.url?scp=85030611110&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85030611110&partnerID=8YFLogxK
U2 - 10.1097/MLR.0000000000000798
DO - 10.1097/MLR.0000000000000798
M3 - Article
C2 - 28857962
AN - SCOPUS:85030611110
VL - 55
SP - 879
EP - 885
JO - Medical Care
JF - Medical Care
SN - 0025-7079
IS - 10
ER -