Perceived Ambiguity about Screening Mammography Recommendations: Association with Future Mammography Uptake and Perceptions

P. K.J. Han, S. C. Kobrin, W. M.P. Klein, W. W. Davis, M. Stefanek, S. H. Taplin
2007 Cancer Epidemiology, Biomarkers and Prevention  
Conflicting expert recommendations regarding cancer screening and prevention are growing in number, visibility, and importance, but their impact are not well understood. In this study, we examined the impact of conflicting recommendations about mammography screening on women's mammography behavior and perceptions. We conducted a secondary analysis of longitudinal data from the 1995 Maximizing Mammography Participation Trial, a large randomized interventional trial examining the effectiveness of
more » ... he effectiveness of patient reminders in increasing mammography utilization among women ages 50 to 79. Using the decision theory concept of "ambiguity" as an analytic framework, we tested several predictions about the effects of conflicting recommendations regarding mammography recommendations on behavior, cognitions, and emotions related to mammography screening. We found high perceived ambiguity about mammography recommendations to be associated with both diminished uptake of mammography over time [odds ratio (OR), 0.42; 95% confidence interval (95% CI), 0.23-0.76; P < 0.0001] and lower intentions for future mammography (OR, 0.34; 95% CI, 0.20-0.55; P < 0.0001). High perceived ambiguity also predicted greater mammography-related worry over time (OR, 2.60; 95% CI, 1.79-3.78; P < 0.0001). These findings suggest that conflicting recommendations regarding cancer screening and prevention have important effects, and we discuss the implications of these findings for future research. (Cancer Epidemiol Biomarkers Prev 2007;16(3):458 -66) Cancer Epidemiol Biomarkers Prev Downloaded from c 0.80 (0.62-1.03) NOTE: Total sample N = 3,701 (decreased and unequal n for individual models due to missing data). Abbreviations: OR, odds ratio; 95% CI, 95% confidence interval. *P for Wald m 2 of association. c"Somewhat higher" and "Much higher" categories collapsed to accommodate small cell sizes in the model.
doi:10.1158/1055-9965.epi-06-0533 pmid:17372241 fatcat:vkmk3nzmgnbfzg23ntlu4oabhu