Breast cancer screening in Australian general practice: results of a national survey

Objective: To determine current beliefs and knowledge about, and use of, two screening tests for breast cancer (mammography and clinical breast examination [CBE]) among general practitioners (GPs). Design, participants and setting: National postal survey of randomly selected GPs from throughout Australia in May 1996. Main outcome measures: Belief in the effectiveness of each screening test in reducing premature deaths from breast cancer; recommended age group and screening interval for each test; likelihood of including each opportunistically or in a health check-up. Predictors were determined by regression analyses. Results: The response rate was 67% (855/1271). Significantly more respondents believed in the effectiveness of mammography than of CBE (92% v. 66%). About half identified women 50 years and over as the appropriate target group for mammography. Only 40% indicated they would be "highly likely" to discuss mammography opportunistically, although 82% would be "highly likely" to discuss it in a health check-up. After adjusting for confounders, female GPs were more likely to discuss mammographic screening and to advocate a biennial frequency. Older GPs and those from New South Wales were least likely to recommend mammography (consistent with the national policy). Significantly more respondents were "highly likely" to discuss CBE than mammography in a health check-up. Conclusions: GPs are convinced of the effectiveness of mammography, but as respondents were more likely to screen by CBE than to recommend mammography in a dedicated health check-up a consistent national policy about CBE would be highly desirable.