What is the psychological impact of mammographic screening on younger women with a family history of breast cancer? Findings from a prospective cohort study by the PIMMS Management Group.
OBJECTIVE
Studies are underway to establish the clinical effectiveness of annual mammographic screening in women younger than 50 years with a family history of breast cancer. This study investigated both the positive and negative psychological effects of screening on these women.


METHODS
Women who received an immediate all-clear result after mammography (n = 1,174) and women who were recalled for additional tests before receiving an all-clear result (false positive; n = 112) completed questionnaires: 1 month before mammography, and 1 and 6 months after receiving final results. The questionnaires included measures of cancer worry, psychological consequences, and perceived benefits of breast screening.


RESULTS
Women who received an immediate all-clear result experienced a decrease in cancer worry and negative psychological consequences immediately after the result, whereas women who were recalled for additional tests did not. By 6 months this cancer-specific distress had reduced significantly in both groups. Changes in levels of distress were significantly different between the two groups, but in absolute terms the differences were not large. Recalled women reported significantly greater positive psychological consequences of screening immediately after the result, and were also more positive about the benefits of screening compared with women who received an immediate all-clear result.


CONCLUSIONS
For women receiving an immediate all-clear result, participating in annual mammographic screening is psychologically beneficial. Furthermore, women who are recalled for additional tests do not appear to be harmed by screening: these women's positive views about mammography suggest that they view any distress caused by recall as an acceptable part of screening.
Tyndel
Sally
S
Cancer Research UK, Primary Care Education Research Group, Division of Public Health, Primary Health Care, University of Oxford, Oxford, United Kingdom.
Austoker
Joan
J
Henderson
Bethan J
BJ
Brain
Kate
K
Bankhead
Clare
C
Clements
Alison
A
Watson
Eila K
EK
D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics* / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D008327:Mammography / Q000523:psychology*; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged; D011159:Population Surveillance; D006113:United Kingdom