title: Screening in the era of economic crisis: misperceptions and misuse from a longitudinal study on Greek women undergoing benign vacuum-assisted breast biopsy.
abstract: BACKGROUND
  To evaluate knowledge about screening tests and tests without proven screening value in a Greek Breast Unit population undergoing benign vacuum-assisted breast biopsy (VABB).
  
  
  METHODS
  This study included 81 patients. Three knowledge-oriented items (recommended or not, screening frequency, age of onset) were assessed. Regarding screening tests two levels of knowledge were evaluated: i). crude knowledge (CK), i.e. knowledge that the test is recommended and ii). advanced knowledge (AK), i.e. correct response to all three knowledge-oriented items. Solely CK was evaluated for tests without proven screening value. Risk factors for lack of knowledge were assessed with multivariate logistic regression. A second questionnaire was administered 18 months after VABB to assess its impact on the performance of tests.
  
  
  RESULTS
  Concerning screening tests considerable lack of AK was noted (mammogram, 60.5%; Pap smear, 59.3%; fecal occult blood testing, 93.8%; sigmoidoscopy, 95.1%). Similarly lack of CK was documented regarding tests without proven screening value (breast self-examination, 92.6%; breast MRI, 60.5%; abdominal ultrasound, 71.6%; barium meal, 48.1%; urine analysis, 90.1%; chest X-Ray, 69.1%; electrocardiogram, 74.1%; cardiac ultrasound, 75.3%). Risk factors for lack of AK were: place of residence (mammogram), age (Pap smear), personal income (sigmoidoscopy); risk factors for lack of CK included number of offspring (breast MRI, chest X-Ray), BMI (abdominal ultrasound), marital status (urine analysis), current smoking status (electrocardiogram). VABB's only effect was improvement in mammogram rates.
  
  
  CONCLUSIONS
  A considerable lack of knowledge concerning screening tests and misperceptions regarding those without proven value was documented.
authors.affiliation: Breast Unit, Department of Propaedeutic Surgery, Hippokrateio Hospital, Medical School, University of Athens, Korinthos, Greece E-mail : philip.domeyer@gmail.com.
authors.forename: Philip John
authors.initials: PJ
authors.lastname: Domeyer
authors.forename: Theodoros Nikolaos
authors.initials: TN
authors.lastname: Sergentanis
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Katsari
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Souliotis
authors.forename: Anargiros
authors.initials: A
authors.lastname: Mariolis
authors.forename: Flora
authors.initials: F
authors.lastname: Zagouri
authors.forename: George Constantine
authors.initials: GC
authors.lastname: Zografos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000523:psychology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D016504:Breast Self-Examination; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D006115:Greece; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000523:psychology; D008327:Mammography / Q000523:psychology*; D008875:Middle Aged; D009780:Occult Blood; D065006:Papanicolaou Test / Q000523:psychology; D012812:Sigmoidoscopy / Q000523:psychology; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000523:psychology; D014618:Vacuum; D014626:Vaginal Smears / Q000523:psychology