Society Guidelines Influence Mammography Screening Recommendations

How often specialists recommend mammography screening to patients is influenced by their professional societies’ guidelines.

When making recommendations to patients regarding breast cancer screening, physicians seem to be influenced by their own society’s recommendations, according to a study published in the American Journal of Roentgenology.

Researchers from the University of Washington School of Medicine in Seattle sought to determine if primary care physicians were influenced by their own specialty society's mammography screening recommendations after the 2009 USPSTF revised recommendations were released.

The researchers used data obtained from the National Ambulatory Medical Care Survey (NAMCS), including all office-based preventive services visits for women 40 years old or older, resulting in 35,947,290 office visits per year. In 2009, the UUSPSTF updated its breast cancer screening recommendations to biennual screening for women who were aged between 50 and 74. After this, both the American Academy of Family Physicians (AAFP) and American College of Physicians (ACP) adopted the same recommendation for this age group. The American College of Obstetricians and Gynecologists (ACOG) continues to recommend annual screening at age 40.

The results showed that, overall, mammography referral rates per 1,000 visits decreased from 285 to 215 referrals from 2007-2008 to 2011-2012.

Decreases per specialty, per 1,000 visits:

SpecialtyDecrease in referrals
Family physicians230 to 128
Internal medicine physicians135 to 79
Obstetricians and gynecologists476 to 419

The researchers concluded that both family and internal medicine physicians, showed statistically significant decreases in mammography referral rates over time, in accordance to their societies’ recommendations. Obstetricians and gynecologists showed no statistically significant change in mammography referral rates over time.