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Women Still Insist on Cancer Screenings

A vast majority of American women plan to ignore controversial new recommendations about mammograms, a USA TODAY/Gallup Poll shows. The poll also shows that most women sharply overestimate their risk of developing the disease.

The U.S. Preventive Services Task Force, an independent panel of government-appointed experts, suggested last week that most women don't need routine mammograms until age 50. The panel had told women to begin breast cancer screening at age 40.

Women across the USA have reacted angrily to the recommendations and expressed concern that delaying the tests could endanger their lives. In the new survey of 1,136 women, 76% of women say they disagree or strongly disagree with the recommendations.

And 84% of women ages 35 to 49 say they plan to get mammograms before age 50 despite the independent panel's advice. That's in keeping with the guidance of the American Cancer Society, which recommends annual mammograms beginning at age 40.

Yet while the respondents expressed strong emotions about mammograms, the poll found that most women have misconceptions about the disease and the panels' motives.

Seventy-six percent of women believe that the panel based its conclusions on cost, even though the task force's report included only scientific studies. Women also perceive their breast cancer risk to be higher than it really is. Forty percent of women estimate that a 40-year-old's chance of developing breast cancer over the next decade is 20% to 50%. The real risk is 1.4%, according to the National Cancer Institute.

"It's gratifying that most women have gotten the message that they should get a mammogram and get it annually," says Otis Brawley, the cancer society's chief medical officer. "Unfortunately, your poll also shows that we still need to do a lot in terms of health education."

The task force didn't rule out mammograms for women under age 50, but it suggested that women in their 40s talk to their doctors about the benefits and risks of screening, which include false alarms and even unnecessary treatment. Ten percent to 33% of early breast tumors have no potential to kill, Brawley says. Because doctors can't be certain which tumors will prove deadly, they tend to treat all of them, which subjects some women to unneeded therapies.

Most women hear only about the benefits of mammograms, and few realize that doctors have been hotly debating their use for more than a decade, says Steve Woloshin, a physician at the Veterans Affairs Outcomes Group in White River Junction, Vt.

Doctors need to do a better job of explaining these risks to patients, and that might help women feel less suspicious about efforts to target mammogram use, Woloshin says.

The telephone survey has a margin of error of 4 percentage points, but the margin of error for questions posed only to the 284 women ages 35 to 49 is 7 percentage points.

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