Poor patient comprehension of abnormal mammography results.
BACKGROUND
Screening mammography for women 50 to 69 years of age may lead to 50% having an abnormal study. We set out to determine the proportion of women who understand their abnormal mammogram results and the factors that predict understanding.


METHODS
We surveyed 970 women age 40 to 80 years identified with abnormal mammograms from 4 clinical sites. We collected information on demographic factors, language of interview, consultation with a primary care physician, receipt of follow-up tests, and method of notification of index mammogram result. This study examines the following outcomes: the participant's report of understanding of her physician's explanation of results of the index mammogram, and a comparison of the radiology report to the participant's report of her index mammogram result. Multivariate models controlled for age, education, income, insurance status, and clinical site.


RESULTS
The majority (70%) reported a "full understanding" of their physician's explanation of their abnormal mammogram, but a significant minority (30%) reported less than a full understanding (somewhat, not at all, did not explain). Among women of Asian ethnicity, only 63% reported full understanding. Asian ethnicity was a negative predictor (odds ratio [OR], 0.4; 95% confidence interval [CI], 0.3 to 0.7), and consultation with a primary care physician was a positive predictor (OR, 2.3; 95% CI, 1.7 to 3.3) of reported full understanding. Of the 304 women with a suspicious abnormality, only 51% understood their result to be abnormal. Women notified in person or by telephone were more likely than women notified in writing to understand their result to be abnormal (OR, 2.3; 95% CI, 1.2 to 4.8).


CONCLUSIONS
Almost half of women with the most suspicious mammograms did not understand that their result was abnormal. Our data suggest that direct communication with a clinician in person or by phone improves comprehension.
Karliner
Leah S
LS
Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, Center for Aging in Diverse Communities, University of California, San Francisco, USA.
Patricia Kaplan
Celia
C
Juarbe
Teresa
T
Pasick
Rena
R
Pérez-Stable
Eliseo J
EJ
D000328:Adult; D000368:Aged; D003142:Communication; D032882:Comprehension; D005260:Female; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000523:psychology; D008875:Middle Aged; D015999:Multivariate Analysis; D010817:Physician-Patient Relations