Screening mammography: referral practices of Los Angeles physicians

The American Cancer Society (ACS) recommends annual screening mammography for asymptomatic women over 50 years old. In a survey of attitudes and referral practices toward screening mammography, one-fifth (886) of the 4200 physicians queried returned a postage-paid questionnaire. Only 11% of respondents followed the ACS guidelines. Physicians under 40 years old, in group practice, or in surgical specialties were more apt to refer their patients for screening. The major deterrent to referral was the perceived high cost and low yield of screening. However, 80% of the physicians indicated they would refer patients over 50 who requested annual screening. Annual mammography screening is underused; greater efforts must be directed toward educating physicians and patients regarding its value and toward lowering its cost.