ASPO Abstracts
Patient awareness of elevated breast cancer risk after routine screening mammogram and risk notification
Category: Behavioral Science & Health Communication
Conference Year: 2023
Abstract Body:
Background: Population-based screening for breast cancer (BC) risk, which pairs regular mammograms with risk prediction modeling, can identify women with ≥20% lifetime risk to facilitate risk-management counseling. In 2019, the Ohio State University Wexner Medical Center (OSUWMC) started assessing lifetime BC risk for all women undergoing routine screening mammography. Those found to have ≥20% lifetime risk are notified and advised to consult a healthcare provider. Purpose of Study: To assess the degree to which women remembered receiving the notification letter and recalled its content, at points up to 1 year after receiving the notification. Methods: Eligible individuals were all those aged ≥18 years who received a routine screening mammogram at one of OSUWMC's 14 mammography sites between April 2019 and October 2020, and whose risk prediction modeling indicated that they may be at ≥20% lifetime BC risk. Participants completed an online survey approximately 2 weeks (n=152), 3 months (158), or 1 year (149) after receiving the risk notification. Descriptive analyses were used to assess recall of the notification and its content. Results: A total of 459 participants, aged 39-69 years [mean=50.5 years (SD=7.3)] were mostly white (90%) with a bachelor's degree or higher (78.4%) and above- median income (52.1%). Most recalled receiving the notification (66.9%), perceived the information not to be complex (47.1%), and were confident they understood the notification (61.0%). Among those who remembered the notification, about half recalled one of its two messages: that they may be at elevated risk (52.1%) or the suggestion to discuss their risk with a provider (50.1%). Only 31.6% of participants recalled both messages. A statistically significant higher proportion of participants remembered receiving the notification after only 2 weeks (71.5%) compared to 3 months (59.5%) or 1 year (59.7 %) (p<0.05). Recall of the elevated risk message followed the same pattern (63.6% 2 weeks, 47.0% 3 months, 44.3% 1 year) (p<0.05). Conclusions: These findings indicate that population-based screening has potential to provide patients with valuable information, but that communicating elevated risk status and the need to talk to a provider may require more than a notification letter.
Keywords: Population-based screening, high lifetime breast cancer risk