Women's Attitudes toward the 2024 US Preventive Services Task Force Mammography Screening Guideline

From 2009 to 2024, the US Preventive Services Task Force (USPSTF) recommended that women aged 40 to 49 y make an informed choice about when to begin having mammograms. In 2024, the USPSTF changed its guidelines, recommending biennial screening from age 40 to 74 y. This study investigated women's attitudes toward the guideline change. Moreover, since the evidence for screening benefit and harm changed very little from past estimates, a randomized experiment tested whether providing this information would affect participants' evaluations.

A total of 466 women aged 39 to 49 y without a history of breast cancer were enrolled in a longitudinal study and exposed to a mammography decision aid (DA). After the USPSTF guideline was announced in April 2024, these participants were recontacted to take a survey informing them of the guideline change and asking them to report their attitudes toward it. In total, 301 (mean age = 43.3 y, SD = 2.9 y; 68.4% White; 9.0% Hispanic) participants took the survey and were randomized into 1 of two conditions, one presenting basic information about the guideline change and the other additionally communicating updated benefit and harm data. Outcomes included attitudes toward the new guideline and associated rationales, trust in the USPSTF, and perceived mammography benefit and harm.

The experimental conditions had no effect on any outcome (all Ps > 0.05). On average, attitudes toward the new guideline were positive (61% "positive" or "very positive"), trust in the USPSTF was moderately high (M = 5.57, SD = 1.00, 1-7 scale), and participants perceived high screening benefit (M = 4.34, SD = 0.80; 1-5 scale) and low harm (M = 1.81, SD = 0.73; 1-5 scale). Differences of opinion were observed regarding screening frequency, suggesting that screening frequency is preference sensitive.

Most women evaluated the 2024 USPSTF guideline positively, trusted the USPSTF, and perceived screening as beneficial and minimally harmful. There was no evidence that women's attitudes were influenced by the minimal change in evidence for mammography benefit and harm.