Screening Mammography for Young Women in Israel: Between Guidelines and Common Practice

Area of Science:

• Oncology
• Radiology
• Public Health

Background:

• Breast cancer screening mammography for women under 50 is controversial due to benefits versus risks.
• Adherence to screening guidelines for this demographic is globally low.
• In Israel, specific criteria exist for early screening, but adherence is questionable.

Purpose of the Study:

• To report on screening mammography referrals for young women in Israel.
• To assess adherence to established guidelines for these referrals.
• To identify factors influencing guideline adherence.

Main Methods:

• A cross-sectional study analyzed 999 screening mammography referral letters for women aged 18-49 in Israel.
• Referrals were categorized as adherent or nonadherent to guidelines.
• Factors like patient age, comorbidities, and referring physician specialty were examined.

Main Results:

• Only 10.9% of referrals strictly adhered to guidelines; 30.6% adhered under a lenient approach.
• Referrals were more common for women over 40.
• General surgeons made 45% of referrals, with higher adherence rates than gynecologists.

Conclusions:

• A significant gap exists between evidence-based guidelines and clinical practice for breast cancer screening in women under 50 in Israel.
• Physician specialty influences adherence to screening guidelines.
• Current practices deviate from recommendations, necessitating improved guideline implementation.