Interventions to promote repeat breast cancer screening with mammography

	Tweet

Researchers have been trying to determine the best strategy for women who can potentially benefit from repeat mammography screening. A recent meta-analysis shows that there is no one single intervention that is best, according to a study published online June 29 in The Journal of the National Cancer Institute.

Regular mammography screening has been shown to reduce breast cancer mortality in women between the ages of 50 and 74 by approximately 23%. However, until 2001, only about half of eligible women have made use of repeat mammography screening. But the surge in recent usage of mammography (women getting them within the past two years), has far outpaced regular or repeat mammography usage. Various interventions, including educational outreach and counseling, have been tried to encourage more regular use of mammography.

To investigate the effectiveness of these intervention strategies, Sally W. Vernon, MD, of the Center for Health Promotion and Prevention Research at the University of Texas-Houston, and colleagues, looked at 25 studies that reported estimates of repeat screening for interventions and control groups. They looked at electronic databases through August 2009. 

The intervention strategies used by the studies were grouped into three categories: reminders, education/motivation, and counseling. The studies were also classified according to the counseling protocols used, and whether single or multiple interventions were used.

The authors found that the studies were heterogeneous, that is, they differed in their conclusions about similar interventions. This finding could be attributed to a lack of standardization among interventions, or different populations or settings.

They noted that this meta-analysis was limited in its ability to measure the effects of interventions for repeat screening because several studies used interventions not explicitly designed to promote repeat mammography; in addition, many of the studies were conducted over ten years ago.

The authors concluded that integration of individual behavioral interventions with structural-level changes may create sustainable improvements in adherence to breast cancer screening. But more studies are needed.

“If we are to reap the benefits of mortality reduction from mammography screening, we need a better understanding of the determinants of repeat screening behavior so that we can develop more effective interventions,” the authors write.

In an accompanying editorial, Dr. Jeanne Mandelblatt of Georgetown University Medical Center and Diana Buist, PhD, of the Group Health Research Institute at the University of Washington, write that one of the obstacles to defining the most effective interventions for promoting regular mammography adherence is that women may be choosing not to use mammography because of publicity about mis-diagnoses.

“It could be reasonably argued that we should better spend our efforts in discovering better early detection tests rather than continuing to invest in getting a few more women to regularly use a flawed technology,” the authors write, adding that proteomics and gene expression profiling methods are two of the tools used to identify potential biomarkers for screening tests.

“It is no longer enough to simply conduct more interventions to understand which work best in motivating individuals to undergo repeat cancer screening,” the authors write. “New paradigms, guided by evidence from modeling, novel trials, and new scientific discovery, will be needed to realize the promise of eliminating the burden of cancer.”

###

Contacts:

Article: Jane A. Waddy, Media Relations Specialist, the University of Texas Health Science Center at Houston, 713-500-3030,

Editorial: Karen Mallet, media contact, 215-514-9751

Contact: Kristine Crane

301-841-1285
Journal of the National Cancer Institute

RELATED STORIES:
Wet ear wax and unpleasant body odors signal breast cancer risk   Breast cancer may be on the rise in U.S.-based Latinas   Breast cancer and pregnancy   Porter Adventist Hospital Breast Program Approved by NAPB   Breast Cancer Risk Found High After Chest Radiation for Hodgkin’s   Vaccine against HER2-positive breast cancer offers complete protection in lab   Smoking not linked to more advanced breast cancer   Radiation After Mastectomy Improves Breast Cancer Survival   Beta-blockers tied to breast cancer survival   Women at risk of breast cancer decline tamoxifen   Gene explains breast cancer chemotherapy outcomes   Gene test helps select breast cancer chemotherapy   Protein from Pregnancy Hormone May Prevent Breast Cancer   Nearly half of women with advanced breast cancer in the US not receiving life-saving treatment   Metabolic syndrome predicts breast cancer relapse   Breast cancer incidence is lower for Latinas   Validation of a tool for identifying women at high risk for hereditary breast cancer   Reconstruction surgery rarely discussed with breast cancer patients   Breast cancer risk after false-positive mammography results   Breast Ducts: A New Site for Cancer Treatment?   Teaching Breast Health Early to Reduce Breast Cancer Mortality in D.C.   High CTC levels predicted poor outcome in metastatic breast cancer

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]