Screening Mammography Over-Recommended in Terminally Ill

Physician specialty, gender, minority status, and size of practice impact over-recommendation

THURSDAY, Dec. 22 (HealthDay News) -- Over-recommendation of screening mammography for women with a terminal comorbidity is common, and is associated with physician and practice characteristics, including specialty, gender, race, and size of practice, according to a study published in the Jan. 1 issue of Cancer.

Corinne R. Leach, Ph.D., M.P.H., from the National Cancer Institute in Bethesda, Md., and colleagues sought to identify the characteristics of physicians who recommend mammography for terminally ill women. Data were analyzed from a nationally representative survey of 1,196 primary care physicians (PCPs) conducted in 2006 and 2007. The survey assessed their breast cancer screening recommendations for hypothetical 50-, 65-, and 80-year-old patients who were either healthy, had a moderate comorbidity, or a had terminal comorbidity.

The investigators found that 47.7 percent of the PCPs indicated that they would recommend a mammogram for women from all three age groups with a diagnosis of terminal lung cancer. Being an obstetrician/gynecologist, an internal medicine specialist, a woman, a racial/ethnic minority, or working in a smaller practice were all physician characteristics that were associated with over-recommendation of mammography (odds ratios, 1.69, 0.45, 1.40, 1.72, and 1.41, respectively).

"The current results indicated that physician over-recommendation of screening mammography among terminally ill women is common. Certain physician and practice characteristics, including specialty, were associated with over-recommending mammography," the authors write.

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