Scientific uncertainty and perceived mammography benefits in women screened for breast cancer

Cancer Causes Control. 2023 Jul;34(7):611-619. doi: 10.1007/s10552-023-01697-9. Epub 2023 Apr 21.

Abstract

Purpose: Personal aversion to scientific uncertainty may influence how women perceive the benefits of mammography, a breast cancer screening practice with conflicting scientific opinions and guidelines. Such associations may even exist among women who participate in screening.

Methods: We evaluated the distribution of aversion to ambiguous medical information (AA-Med), using a 6-item scale capturing the level of agreement with statements about obtaining a cancer screening test with conflicting medical recommendations in 665 women (aged 40-60 years; 79.5% Hispanic) recruited during screening mammography appointments in New York City. We assessed the association of AA-Med with perceptions of benefits of mammography (breast cancer mortality reduction, worry reduction, early detection, treatment improvement) using multivariable logistic regression.

Results: Over a quarter of participants expressed negative reactions to medical ambiguity about a cancer screening test (e.g., fear, lower trust in experts), but a majority endorsed intention to undergo screening. AA-Med was higher in women who were U.S.-born, non-Hispanic black, and had marginal to adequate health literacy, but there were no differences by clinical factors or screening experiences (e.g., family history, prior breast biopsy). Women with higher AA-Med were more likely to perceive treatment benefits from mammography (OR = 1.37, 95% CI = 0.99-1.90), but AA-Med was not associated with other perceived mammography benefits.

Conclusions: Aversion to uncertainty regarding cancer screening varies by sociodemographic characteristics but has limited associations with perceived mammography benefits in women who already participate in screening.

Keywords: Ambiguity aversion; Cancer screening; Conflicting evidence; Mammography; Uncertainty.

MeSH terms

  • Breast
  • Breast Neoplasms* / diagnostic imaging
  • Breast Neoplasms* / prevention & control
  • Early Detection of Cancer
  • Female
  • Humans
  • Mammography
  • Mass Screening
  • Uncertainty