PMID- 26129780 OWN - NLM STAT- MEDLINE DCOM- 20161013 LR - 20181113 IS - 1525-1497 (Electronic) IS - 0884-8734 (Print) IS - 0884-8734 (Linking) VI - 31 IP - 1 DP - 2016 Jan TI - Provider Attitudes and Screening Practices Following Changes in Breast and Cervical Cancer Screening Guidelines. PG - 52-9 LID - 10.1007/s11606-015-3449-5 [doi] AB - BACKGROUND: Changes to national guidelines for breast and cervical cancer screening have created confusion and controversy for women and their primary care providers. OBJECTIVE: To characterize women's primary health care provider attitudes towards screening and changes in practice in response to recent revisions in guidelines for breast and cervical cancer screening. DESIGN, SETTING, PARTICIPANTS: In 2014, we distributed a confidential web and mail survey to 668 women's health care providers affiliated with the four clinical care networks participating in the three PROSPR (Population-based Research Optimizing Screening through Personalized Regimens) consortium breast cancer research centers (385 respondents; response rate 57.6 %). MAIN MEASURES: We assessed self-reported attitudes toward breast and cervical cancer screening, as well as practice changes in response to the most recent revisions of the U.S. Preventive Services Task Force (USPSTF) recommendations. KEY RESULTS: The majority of providers believed that mammography screening was effective for reducing cancer mortality among women ages 40-74 years, and that Papanicolaou (Pap) testing was very effective for women ages 21-64 years. While the USPSTF breast and cervical cancer screening recommendations were widely perceived by the respondents as influential, 75.7 and 41.2 % of providers (for mammography and cervical cancer screening, respectively) reported screening practices in excess of those recommended by USPSTF. Provider-reported barriers to concordance with guideline recommendations included: patient concerns (74 and 36 % for breast and cervical, respectively), provider disagreement with the recommendations (50 and 14 %), health system measurement of a provider's screening practices that use conflicting measurement criteria (40 and 21 %), concern about malpractice risk (33 and 11 %), and lack of time to discuss the benefits and harms with their patients (17 and 8 %). CONCLUSIONS: Primary care providers do not consistently follow recent USPSTF breast and cervical cancer screening recommendations, despite noting that these guidelines are influential. FAU - Haas, Jennifer S AU - Haas JS AD - Brigham and Women's Hospital, Boston, MA, USA. jhaas@partners.org. AD - Harvard Medical School, Boston, MA, USA. jhaas@partners.org. AD - Harvard T.H. Chan School of Public Health, Boston, MA, USA. jhaas@partners.org. AD - Division of General Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA. jhaas@partners.org. FAU - Sprague, Brian L AU - Sprague BL AD - University of Vermont, Burlington, VT, USA. FAU - Klabunde, Carrie N AU - Klabunde CN AD - Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD, USA. FAU - Tosteson, Anna N A AU - Tosteson AN AD - Geisel School of Medicine at Dartmouth and Norris Cotton Cancer Center, Lebanon, NH, USA. FAU - Chen, Jane S AU - Chen JS AD - Brigham and Women's Hospital, Boston, MA, USA. FAU - Bitton, Asaf AU - Bitton A AD - Brigham and Women's Hospital, Boston, MA, USA. AD - Harvard Medical School, Boston, MA, USA. FAU - Beaber, Elisabeth F AU - Beaber EF AD - Fred Hutchinson Cancer Research Center, Seattle, WA, USA. FAU - Onega, Tracy AU - Onega T AD - Geisel School of Medicine at Dartmouth and Norris Cotton Cancer Center, Lebanon, NH, USA. FAU - Kim, Jane J AU - Kim JJ AD - Harvard T.H. Chan School of Public Health, Boston, MA, USA. FAU - MacLean, Charles D AU - MacLean CD AD - University of Vermont, Burlington, VT, USA. FAU - Harris, Kimberly AU - Harris K AD - Brigham and Women's Hospital, Boston, MA, USA. FAU - Yamartino, Phillip AU - Yamartino P AD - University of Pennsylvania and the Philadelphia VA Medical Center, Philadelphia, PA, USA. FAU - Howe, Kathleen AU - Howe K AD - University of Vermont, Burlington, VT, USA. FAU - Pearson, Loretta AU - Pearson L AD - Geisel School of Medicine at Dartmouth and Norris Cotton Cancer Center, Lebanon, NH, USA. FAU - Feldman, Sarah AU - Feldman S AD - Brigham and Women's Hospital, Boston, MA, USA. AD - Harvard Medical School, Boston, MA, USA. FAU - Brawarsky, Phyllis AU - Brawarsky P AD - Brigham and Women's Hospital, Boston, MA, USA. FAU - Schapira, Marilyn M AU - Schapira MM AD - University of Pennsylvania and the Philadelphia VA Medical Center, Philadelphia, PA, USA. CN - PROSPR (Population-based Research Optimizing Screening through Personalized Regimens) Consortium LA - eng GR - U54CA 163313/CA/NCI NIH HHS/United States GR - U54 CA163313/CA/NCI NIH HHS/United States GR - U54 CA163307/CA/NCI NIH HHS/United States GR - P01 CA154292/CA/NCI NIH HHS/United States GR - U54 CA163303/CA/NCI NIH HHS/United States GR - P30 CA023108/CA/NCI NIH HHS/United States GR - U54CA164336/CA/NCI NIH HHS/United States GR - U01CA163304/CA/NCI NIH HHS/United States GR - U54 CA164336/CA/NCI NIH HHS/United States GR - U01 CA163304/CA/NCI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural PL - United States TA - J Gen Intern Med JT - Journal of general internal medicine JID - 8605834 SB - IM CIN - J Gen Intern Med. 2016 Jan;31(1):103. PMID: 26259763 MH - Adult MH - *Attitude of Health Personnel MH - Breast Neoplasms/*diagnosis/epidemiology MH - Early Detection of Cancer/*standards MH - Female MH - Humans MH - Middle Aged MH - Morbidity/trends MH - *Practice Guidelines as Topic MH - Retrospective Studies MH - Survival Rate/trends MH - United States/epidemiology MH - Uterine Cervical Neoplasms/*diagnosis/epidemiology PMC - PMC4700005 OTO - NOTNLM OT - breast cancer screening OT - cervical cancer screening OT - clinical practice guidelines OT - primary care OT - provider practice patterns EDAT- 2015/07/02 06:00 MHDA- 2016/10/14 06:00 PMCR- 2017/01/01 CRDT- 2015/07/02 06:00 PHST- 2015/07/02 06:00 [entrez] PHST- 2015/07/02 06:00 [pubmed] PHST- 2016/10/14 06:00 [medline] PHST- 2017/01/01 00:00 [pmc-release] AID - 10.1007/s11606-015-3449-5 [pii] AID - 3449 [pii] AID - 10.1007/s11606-015-3449-5 [doi] PST - ppublish SO - J Gen Intern Med. 2016 Jan;31(1):52-9. doi: 10.1007/s11606-015-3449-5.