title: Physician adherence to U.S. Preventive Services Task Force mammography guidelines.
abstract: BACKGROUND
  In 2009, the U.S. Preventive Services Task Force (USPSTF) guidelines for screening mammography changed significantly, and are now in direct conflict with screening guidelines of other major national organizations. The extent to which physicians in different primary care specialties adhere to current USPSTF guidelines is unknown.
  
  
  METHODS
  We conducted a cross-sectional web-based survey completed by 316 physicians in internal medicine, family medicine (FM), and gynecology (GYN) from February to April 2012. Survey items assessed respondents' breast cancer screening recommendations in women of different ages at average risk for breast cancer. We used descriptive statistics to generate response distribution for survey items, and logistic regression models to compare responses among specialties.
  
  
  RESULTS
  The response rate was 55.0% (316/575). A majority of providers in internal medicine (65%), FM (64%), and GYN (92%) recommended breast cancer screening starting at age 40 versus 50. A majority of providers in internal medicine (77%), FM (74%), and GYN (98%) recommended annual versus biennial screening. Gynecologists were significantly more likely than both internists and family physicians to recommend initial mammography at age 40 (p ≤ .0001) and yearly mammography (p = .0003). There were no other differences by respondent demographic.
  
  
  CONCLUSIONS
  Primary care providers, especially gynecologists, have not implemented USPSTF guidelines. The extent to which these findings may be driven by patient versus provider preferences should be explored. These findings suggest that patients are likely to receive conflicting breast cancer screening recommendations from different providers.
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: corbellija@upmc.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Corbelli
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for Research Health Equity and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Center for Research on Health Care, University of Pittsburgh Center for Research on Health Care, Pittsburgh, Pennsylvania.
authors.forename: Sonya
authors.initials: S
authors.lastname: Borrero
authors.affiliation: Division of General Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Rachel
authors.initials: R
authors.lastname: Bonnema
authors.affiliation: Division of General Internal Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio; Louis Stokes VA Healthcare System, Cleveland, Ohio.
authors.forename: Megan
authors.initials: M
authors.lastname: McNamara
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for Research on Health Care, University of Pittsburgh Center for Research on Health Care, Pittsburgh, Pennsylvania.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kraemer
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for Research on Health Care, University of Pittsburgh Center for Research on Health Care, Pittsburgh, Pennsylvania.
authors.forename: Doris
authors.initials: D
authors.lastname: Rubio
authors.affiliation: Center for Research on Health Care, University of Pittsburgh Center for Research on Health Care, Pittsburgh, Pennsylvania.
authors.forename: Irina
authors.initials: I
authors.lastname: Karpov
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Melissa
authors.initials: M
authors.lastname: McNeil
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000517:prevention & control; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008327:Mammography / Q000592:standards*; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration; D014481:United States