Original Article

Healthcare Professionals’ Perceptions and Knowledge of the USPSTF Guidelines on Breast Self-Examination

Authors: Kah Poh Loh, MD, Mihaela S. Stefan, MD, FACP, Jennifer Friderici, MS, Eng Keong Tan, MD, MRCP, Owolabi Ogunneye, MD, MRCP, Reva Kleppel, MSW, MPH, James A. Stewart, MD, FACP

Abstract

Objectives: In 2009, the US Preventive Services Task Force (USPSTF) published revised guidelines for breast cancer screening, which recommended against teaching breast self-examination (BSE). The objective of this study was to assess providers’ perceptions and knowledge regarding these updated guidelines.

Methods: A cross-sectional survey study was administered to 205 attending and resident physicians, nurse practitioners, physician’s assistants, and registered nurses working in five medical and gynecological practices affiliated with a large academic teaching hospital in western Massachusetts. The survey solicited demographic data and inquired about practitioners’ perceptions and knowledge of the revised guidelines.

Results: Fewer than half (41.1%) of respondents correctly identified the new USPSTF guidelines for BSE. Among those who stated they were aware of guidelines, only 37.1% adhered to them. Overall, 70% report that they teach patients to perform BSE. Teaching BSE was associated with female sex (odds ratio [OR] 2.64, 95% confidence interval [CI] 1.11–6.29), a belief that BSE reduces morbidity and mortality (OR 2.91, 95% CI 1.08–7.81), and internal medicine residency (OR 0.18, 95% CI 0.06–0.59).

Conclusions: Knowledge of the 2009 USPSTF guidelines is suboptimal and greater efforts should be made to educate healthcare professionals about them.

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References

1. American Cancer Society. Cancer facts and statistics 2014. http://www.cancer.org/research/cancerfactsstatistics/index. Accessed May 6, 2014.
 
2. Independent UK Panel on Breast Cancer Screening. The benefits and harms of breast cancer screening: an independent review. Lancet 2012;380:1778-1786.
 
3. Nelson HD, Tyne K, Naik A, et al. Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med 2009; 151:727-37, W237-W242.
 
4. Baxter N, Force Canadian Task on Preventive Health Care. Preventive health care, 2001 update: should women be routinely taught breast self-examination to screen for breast cancer? CMAJ 2001;164:1837-1846.
 
5. Kosters JP, Gøtzsche PC. Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database Syst Rev 2003;2:CD003373.
 
6. Thomas DB, Gao DL, Ray RM, et al. Randomized trial of breast self-examination in Shanghai: final results. J Natl Cancer Inst 2002;94:1445-1457.
 
7. Hackshaw AK, Paul EA. Breast self-examination and death from breast cancer: a meta-analysis. Br J Cancer 2003;88:1047-1053.
 
8. American Cancer Society. Breast awareness and self-exam, 2014. http://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf. Accessed March 7, 2014.
 
9. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology, Breast Cancer Screening and Diagnosis Guidelines, V.2.2013. Accessed March 6, 2013.
 
10. Hinz EK, Kudesia R, Rolston R, et al. Physician knowledge of and adherence to the revised breast cancer screening guidelines by the United States Preventive Services Task Force. Am J Obstet Gynecol 2011;205:201.e1-e5.
 
11. United States Census Bureau. State & County QuickFacts. Massachusetts. March 2014. http://quickfacts.census.gov/qfd/states/25000.html. Accessed April 15, 2014.
 
12. Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377-381.
 
13. Nelson HD, Tyne K, Naik A, et al. Screening for breast cancer: systematic evidence review update for the US Preventive Services Task Force. http://www.ncbi.nlm.nih.gov/pubmed/20722173. Published 2009. Accessed May 29, 2015.
 
14. Harvey BJ, Miller AB, Baines CJ, et al. Effect of breast self-examination techniques on the risk of death from breast cancer. CMAJ 1997;157:1205-1212.
 
15. Committee on Gynecologic Practice. Committee opinion no. 534: well-woman visit. Obstet Gynecol 2012;120(2 Pt 1):421-424.