Skip to Main Content
School of Public Health

​
  • Admissions
  • Research
  • Education
  • Practice
​
Search
  • Newsroom
    • School News
    • SPH This Week Newsletter
    • SPH in the Media
    • SPH This Year Magazine
    • News Categories
    • Contact Us
  • Research
    • Centers and Groups
  • Academic Departments
    • Biostatistics
    • Community Health Sciences
    • Environmental Health
    • Epidemiology
    • Global Health
    • Health Law, Policy & Management
  • Education
    • Degrees & Programs
    • Public Health Writing
    • Workforce Development Training Centers
    • Partnerships
    • Apply Now
  • Admissions
    • Applying to BUSPH
    • Request Information
    • Degrees and Programs
    • Why Study at BUSPH?
    • Tuition and Funding
    • SPH by the Numbers
    • Events and Campus Visits
    • Admissions Team
    • Student Ambassadors
    • Frequently Asked Questions
  • Events
    • Public Health Conversations
    • Full Events Calendar
    • Alumni and Friends Events
    • Commencement Ceremony
    • SPH Awards
  • Practice
    • Activist Lab
  • Careers & Practicum
    • For Students
    • For Employers
    • For Faculty & Staff
    • For Alumni
    • Graduate Employment & Practicum Data
  • Public Health Post
    • Public Health Post Fellowship
  • About
    • SPH at a Glance
    • Advisory Committees
    • Strategy Map
    • Senior Leadership
    • Accreditation
    • Diversity, Equity, Inclusion, and Justice
    • Directory
    • Contact SPH
  • Support SPH
    • Big Ideas: Strategic Directions
    • Faculty Research and Development
    • Future of Public Health Fund
    • Generation Health
    • idea hub
    • Public Health Conversations
    • Public Health Post
    • Student Scholarship
    • How to Give
    • Contact Development and Alumni Relations
  • Students
  • Faculty & Staff
  • Alumni
  • Directory
Read More News
Sign and plaque on the facade of The Stonewall Inn on Christopher Street in Greenwich Village, NYC
LGBT health

‘No Community Is Healthy Until All of Its Constituents Are Healthy’

colorful gif of Talbot Building
public health matters

The Long Game of Pride

Choice Is Related to More Breast Cancer Screening.

July 23, 2015
Twitter Facebook

mammography-patient-chartsWomen under 50 who are given a choice about whether to have mammograms are three times more likely to undergo the screening, but improved patient–provider communication does not influence mammography rates, a study led by School of Public Health researchers says.

The study, published in the Journal of Health Communication, found that mammogram utilization was higher among women who perceived being given a choice by their providers about whether to undergo screening. In 2009, breast cancer screening guidelines were updated by the US Preventative Services Task Force to recommend regular screening starting at age 50, rather than 40. The recommendations included a call for shared decision-making (SDM) between doctors and patients, especially for women younger than 50, for whom widespread population screening was no longer recommended.

The study found that few women under age 50—31 percent—perceived that they were being given a choice to undergo screening. But when they did, they were more likely than others to opt for mammography. What was unclear was whether physicians who didn’t give patients a choice instead recommended against mammography, based on the new guidelines.

The results “could be influenced by the content of the physician messages about cancer screenings,” the study says. “Our finding of increased utilization among women who perceived being given a choice . . . may have been the result of differences in provider recommendations.”

The low rate of women who reported that they were given a choice was surprising, the researchers said, given that many professional recommendations suggest using a shared decision-making approach.

“Our findings support the notion that SDM has yet to be fully realized in clinical practice,” the study says. “When patient values are in conflict with expert recommendations, it is an opportune time for physicians to engage in discussions with patients to support more informed decisions about the short- and long-term benefits and risks of screening.”

While choice led to more screening, better patient-provider communication—measured in terms of full explanations and involvement in decisions, for example—did not influence mammography rates. The research team said perceptions of choice may vary based on patient characteristics that are independent of how well physicians communicate. Rates of mammography were higher among women who were married and those who had higher incomes, a cancer history, or a regular care provider.

Interestingly, the study found that women with higher education levels were less likely to receive mammograms. The authors speculated that these women “are either more informed about both benefits and risks, or more likely to be aware of the most current U.S. Preventative Services Task Force recommendations.” They said further research on the interrelationships between SDM factors, education and utilization of screening is needed.

The study was led by Christine M. Gunn, a research assistant professor at the Schools of Medicine and Public Health, and Marina Soley-Bori, a PhD candidate and research assistant at SPH. Co-authors include: Lewis Kazis, professor of health policy and management; Howard Cabral, professor of biostatistics; and Tracy A. Battaglia, associate professor of medicine at the School of Medicine. The study originated with a paper that Gunn and Soley-Bori did in an Advanced Health Services Research Methods Course taught by Kazis and Cabral.

Submitted by: Lisa Chedekel

Explore Related Topics:

  • biostatistics
  • health law
  • policy & management
  • Share this story

Share

Choice Is Related to More Breast Cancer Screening

  • Facebook
  • Reddit
  • LinkedIn
  • Email
  • Print
  • More
  • Twitter

More about SPH

Sign up for our newsletter

Get the latest from Boston University School of Public Health

Subscribe

Also See

  • About
  • Newsroom
  • Contact
  • Support SPH

Resources

  • Students
  • Faculty & Staff
  • Alumni
  • Directory
  • Boston University School of Public Health
  • 715 Albany Street, Boston, MA 02118
  • © 2021 Trustees of Boston University
  • DMCA
  • Facebook
  • YouTube
  • LinkedIn
  • Instagram
  • TikTok
© Boston University. All rights reserved. www.bu.edu
Boston University Masterplate
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.