9th February 2004

A Psychologists Response Concerning Anxiety,

False Positives, False Negatives and

Mammography Choice from 40 years


Consultant Pyschologist to St Marks Breast Centre, Auckland

The issue of anxiety around mammography is a complex one, and saying that women experience stress at the prospect of a mammogram and at the time of having one is true, but that does not necessarily mean a woman will refuse to go ahead and have one, or that the  anxiety is in any way toxic.
My regret around this submission is the very  short time I was given to produce such an important document.
I am not prepared to write a sub standard article, so what I will give you is a brief outline of some of the results from several pieces of research in this area, and you may be able to use them is verbal discussions during the submission process.

1 We know that screening behaviour is determined by a specific pattern of cognitions and affects. In particular, women are more likely to obtain a mammogram if the health message results in a level of cancer worry that motivates rather than interfers with the "actioning"of the woman's behavioural intentions.To achieve that the educational messages need to be designed to acknowledge the feelings of cancer-specific worry and to provide guidence in health protective behaviours. A well constructed message will go a long way to aleviating worry and increasing compliance.

2 Educational health messages that emphasize personal vulnerability ie 'my chances of getting breast cancer at this stage of my life'  are typically related to an increased liklihood of mammography screening. This is  a conclusion of  the meta-analysis quotd below.

The basic summary of the above is that by explaining  and reassuring, worry around mammography can be kept at levels that supportive of participation in, and continued use of a screening programme, at any age.

References; What is The Relationship Between Breast cancer Risk and Mammography screening?A Meta-Analytic review.
Kevin D McCaul et al., Health Psychology 1966,Vol15,No 6 423-429

Specific Worry About Breast Cancer Predicts Mammography Use in Women for Breast  and Ovarian Cancer.

Micheal A.Diefenbach Et Al., Health psychology 1999,Vol 18, No 5, 532-536

Danute Ziginskas