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

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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.

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Data availability

The data used in the current study are not publicly available. Additional approval could be sought by the corresponding author on reasonable request.

Abbreviations

AA-Med:

Aversion to Ambiguity in Medicine

OR:

Odds Ratio

CI:

Confidence Interval

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Acknowledgments

We thank the research participants for contributing data and Rossy Sandoval and Melissa Rodriguez for data collection.

Funding

This work was supported by the National Institutes of Minority Health and Health Disparities under grant (R01 MD011506); Columbia Herbert Irving Comprehensive Cancer Center, NIH/NCI Cancer Center Support under grant (P30CA013696). TA was supported by the National Institutes of Health, National Cancer Institute, Cancer Epidemiology Training Grant (grant number T32-CA009529) during the completion of this study.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Teofilia Acheampong, Carmen B. Rodríguez, Mariangela Agovino, Erica J. Lee Argov & Parisa Tehranifar

  2. Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA

    Suzanne C. O’Neill

  3. Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA

    Parisa Tehranifar

Authors
  1. Teofilia Acheampong
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  2. Carmen B. Rodríguez
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  3. Suzanne C. O’Neill
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  4. Mariangela Agovino
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  5. Erica J. Lee Argov
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  6. Parisa Tehranifar
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Contributions

TA and PT conceived of the study. CBR and MA participated in data collection and management and analysis, all of which was supervised by PT. TA led the statistical analysis and writing of the manuscript. EJLA assisted with data analysis. EJLA and PT contributed substantially to the revisions to the manuscript. All authors provided feedback on the interpretation of results and manuscript drafts. All authors read and approved the final draft.

Corresponding author

Correspondence to Parisa Tehranifar.

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Competing interest

Authors have no competing interests.

Ethical approval

This study was approved by the Internal Review Board of the Columbia University Medical Center.

Informed consent

All participants provided written informed consent.

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Acheampong, T., Rodríguez, C.B., O’Neill, S.C. et al. Scientific uncertainty and perceived mammography benefits in women screened for breast cancer. Cancer Causes Control 34, 611–619 (2023). https://doi.org/10.1007/s10552-023-01697-9

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  • DOI: https://doi.org/10.1007/s10552-023-01697-9

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