International Journal of Epidemiology 2003;32:816-821
© International Epidemiological Association 2003
Health Services Research |
Women’s perception of the benefits of mammography screening: population-based survey in four countries
1 Cantonal Health Office, Via Orico 5, 6500 Bellinzona, Switzerland and Institute of Health Economics and Management (IEMS), University of Lausanne, Switzerland. E-mail: gianfranco.domenighetti{at}ti.ch
2 Laboratory of Epidemiology and Social Psychiatry, Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milan, Italy.
3 MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, UK.
4 Epidemiology Unit, National Cancer Institute Milan, Italy.
5 Institute of Social and Preventive Medicine, University of Geneva, Geneva, Switzerland.
6 Unit for Research on Patient’s Participation in Health Care, Laboratory of Oncological Clinical Research, Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milan, Italy.
7 Division of Epidemiology and Biostatistics, Department of Social & Preventive Medicine, University of Bern, Bern, Switzerland.
Professor Gianfranco Domenighetti, Institute of Health Economics and Management (IEMS) University of Lausanne, Switzerland. E-mail: gianfranco.domenighetti{at}ti.ch
Background Screening programmes are often actively promoted to achieve high coverage, which may result in unrealistic expectations. We examined women’s understanding of the likely benefits of mammography screening.
Methods Telephone survey of random samples of the female population aged 
15 years in the US, UK, Italy, and Switzerland using three closed questions on the expected benefits of mammography screening.
Results A total of 5964 women were contacted and 4140 women (69%) participated. Misconceptions were widespread: a majority of women believed that screening prevents or reduces the risk of contracting breast cancer (68%), that screening at least halves breast cancer mortality (62%), and that 10 years of regular screening will prevent 10 or more breast cancer deaths per 1000 women (75%). In multivariate analysis higher number of correct answers was positively associated with higher educational status (odds ratio [OR] = 1.44, 95% CI: 1.25, 1.66) and negatively with having had a mammography in the last 2 years (OR = 0.86, 95% CI: 0.73, 1.01). Compared with US women (reference group) and Swiss women (OR = 0.98, 95% CI: 0.82, 1.18) respondents in Italy (OR = 0.61, 95% CI: 0.50, 0.74) and the UK (OR = 0.73, 95% CI: 0.60, 0.88) gave fewer correct answers.
Conclusion In the US and three European countries a high proportion of women overestimated the benefits that can be expected from screening mammography. This finding raises doubts on informed consent procedures within breast cancer screening programmes.
Accepted 9 June 2003
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