To describe physician practices with regard to opportunistic screening for breast cancer in women aged 35 to 49 years and 70 years of age and older, and to identify the determinants associated with the practice of prescribing screening mammography.
Postal survey.
Quebec.
Simple random sample of 1400 general practitioners practising in Quebec in 2009.
Five cancer screening practices among 4 types of female clientele and the factors influencing physicians in their practice of prescribing screening mammography.
The response rate was 36%. For women aged 35 to 49 years, more than 80% of physicians reported using practices judged adequate, except for the teaching of breast self-examination and referrals to genetic counseling (60% and 54%). For women 70 years of age and older with good life expectancy, only 50% of general practitioners prescribed screening mammography. For the 70 years of age and older age group without good life expectancy, for whom screening is not indicated, nearly half of physicians continued to do the clinical breast examination and more than one-third reviewed family history. The main determinants for the practice of prescribing mammography are a favourable attitude to screening, screening skills, peer support, belief in the efficacy of mammography, and sufficient knowledge of the issue and of recommendations.
Improvements are needed in the practice of teaching breast self-examination to women aged 35 to 49 years and referring them to genetic counseling, as well as in prescribing mammography for women 70 years of age and older who are in good health. Public health actions to improve these practices should focus on physician attitudes and skills and on communicating clearer recommendations.
Notes
Cites: Prev Med. 1999 Nov;29(5):391-40410564631
Cites: J Immigr Minor Health. 2008 Jun;10(3):239-4617653863
Cites: CMAJ. 2001 Jun 26;164(13):1837-4611450279
Cites: J Am Board Fam Pract. 2001 Sep-Oct;14(5):352-6111572540
Cites: Swiss Med Wkly. 2001 Jun 2;131(21-22):311-911584693
Cites: J Womens Health (Larchmt). 2003 Jan-Feb;12(1):61-7112639370
Cites: Cancer. 2003 Nov 1;98(9):1811-2114584062
Cites: Health Educ Q. 1992 Summer;19(2):157-751618625
Cites: Ann Intern Med. 1994 Apr 1;120(7):602-88117000