Physicians' beliefs about effectiveness of cancer screening tests: A national survey of family physicians, general internists, and obstetrician–gynecologists

Abstract

Objective To study physicians' beliefs about the effectiveness of different tests for cancer screening. Methods Data were examined from the Women's Health Survey of 1574 Family Medicine, Internal Medicine, and Obstetrics–Gynecology physicians to questions about their level of agreement about the clinical effectiveness of different tests for breast, cervical, ovarian, and colorectal cancer screening among average risk women. Data were weighted to the U.S. physician population based on the American Medical Association Masterfile. Multivariable logistic regression identified physician and practice characteristics significantly associated with physicians' beliefs. Results There were 1574 respondents, representing a 62% response rate. The majority of physicians agreed with the effectiveness of mammography for women aged 50–69 years, Pap tests for women aged 21–65 years, and colonoscopy for individuals aged ≥50 years. A substantial proportion of physicians believed that nonrecommended tests were effective for screening (e.g., 34.4% for breast MRI and 69.1% for annual pelvic exam). Physicians typically listed their respective specialty organizations as a top influential organization for screening recommendations. Conclusions There were several substantial inconsistencies between physician beliefs in the effectiveness of cancer screening tests and the actual evidence of these tests' effectiveness which can lead both to underuse and overuse of cancer screening tests.

Scrutinizing screening: a critical interpretive review of primary care provider perspectives on mammography decision-making with average-risk women

“…In two articles [ 28 , 30 ], physician participants were asked to rate the influence of the USPSTF guidelines, and in two others [ 33 , 34 ], these physicians rated their level of trust in different organizations including the USPSTF. Physicians were also asked about the CTFPHC in two articles [ 26 , 27 ], and this guideline was cited in one other article [ 29 ].…”

“…Physicians were also asked about the CTFPHC in two articles [ 26 , 27 ], and this guideline was cited in one other article [ 29 ]. Moreover, the five American studies [ 28 , 30 , 32 – 34 ] made reference to PCPs’ sub-specialties’ guidelines, so mammography recommendations for the American College of Obstetricians and Gynecologists (ACOC), the American Academy of Family Physicians (AAFP), and the American College of Physicians (ACP) are listed. The two North American task force organizations currently recommend routine screening in average-risk women between the ages of 50 and 74.…”

When Guidelines Conflict: A Case Study of Mammography Screening Initiation in the 1990s

“…More recently, a survey of internal medicine (IM), family medicine (FM) and gynecology (GYN) physicians found that physicians in these specialties are more likely to recommend screening initiation at age 40 (65% IM, 64% FM, 92% GYN) than age 50 (Corbelli et al 2014). And a 2014 survey of physicians found that 50.6% of physicians “strongly agree” and 44% of physicians “agree” that mammography screening is “effective” for women ages 40–49 (Miller et al 2014). …”

Cervical Cancer Screening and Prevention in 78 Sexually Transmitted Disease Clinics—United States, 2014–2015

“…9–11 However, identifying women who need cervical cancer screening is often challenging, and both overscreening and underscreening occur. 12–14 Referrals to another institution for cervical cancer screening can result in loss to follow-up. 15 Furthermore, timely follow-up and treatment are required for screening to be effective, and racial, socioeconomic, and other disparities occur.…”