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What Is the Psychological Impact of Mammographic Screening on Younger Women With a Family History of Breast Cancer? Findings From a Prospective Cohort Study by the PIMMS Management Group

Sally Tyndel, Joan Austoker, Bethan J. Henderson, Kate Brain, Clare Bankhead, Alison Clements, Eila K. Watson

From the Cancer Research UK, Primary Care Education Research Group, Division of Public Health, Primary Health Care, University of Oxford, Oxford; Institute of Medical & Social Care Research, Ardudwy, Normal Site, University of Wales, Bangor, Bangor, Gwynedd; and Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom

Address reprint requests to Joan Austoker, PhD, Division of Public Health, Primary Health Care, University of Oxford, Old Road, Headington, Oxford OX3 7LF, United Kingdom; e-mail: joan.austoker{at}dphpc.ox.ac.uk

Purpose Studies are underway to establish the clinical effectiveness of annual mammographic screening in women younger than 50 years with a family history of breast cancer. This study investigated both the positive and negative psychological effects of screening on these women.

Patients and Methods Women who received an immediate all-clear result after mammography (n = 1,174) and women who were recalled for additional tests before receiving an all-clear result (false positive; n = 112) completed questionnaires: 1 month before mammography, and 1 and 6 months after receiving final results. The questionnaires included measures of cancer worry, psychological consequences, and perceived benefits of breast screening.

Results Women who received an immediate all-clear result experienced a decrease in cancer worry and negative psychological consequences immediately after the result, whereas women who were recalled for additional tests did not. By 6 months this cancer-specific distress had reduced significantly in both groups. Changes in levels of distress were significantly different between the two groups, but in absolute terms the differences were not large. Recalled women reported significantly greater positive psychological consequences of screening immediately after the result, and were also more positive about the benefits of screening compared with women who received an immediate all-clear result.

Conclusion For women receiving an immediate all-clear result, participating in annual mammographic screening is psychologically beneficial. Furthermore, women who are recalled for additional tests do not appear to be harmed by screening: these women's positive views about mammography suggest that they view any distress caused by recall as an acceptable part of screening.

Supported by Grant No. C73A2916 from Cancer Research UK.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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				C. K. Kuhl The "Coming of Age" of Nonmammographic Screening for Breast Cancer JAMA, May 14, 2008; 299(18): 2203 - 2205. [Full Text] [PDF]