Awareness of and responses to changes in the National Cancer Institute's guidelines for mammography in women aged 35-49
In 1994, as part of their participation in the University of North Carolina UNC Alumni Heart Study (UNCAHS), 1134 women aged 35-49 years answered five questions designed to assess the impact of the National Cancer Institute's (NCI) changing recommendations about screening mammography for women aged 40-49. The popular press and media frequently covered this topic in November and December 1993. The majority of the women had heard of the NCI's changed recommendations (84%). The main sources of information were newspapers (72%) and radio/TV (70%). Of the 84% of the women who had heard of the recommended changes, 27% reported an intention to reduce their frequency of mammography and 73% reported no changes in their planned behavior. Knowledge of the recommended changes was associated with personality factors, self-rated health, and income, whereas intention to change behavior was associated with the individual's risk of breast cancer and level of achievement striving. The results indicate that women's responses to important health information can be predicted by their personality. Increased hostility, neuroticism, depression, impulsiveness, and vulnerability lead to a reduced likelihood of awareness of changes in the recommendations, and increased extraversion-activity, openness to ideas, competence, and self-discipline lead to an increased likelihood of being aware of the changes in guidelines. The effects of neuroticism, vulnerability, and depression on awareness of changes in NCI guidelines are independent of the effect of sufficiency of income and self-rated health. However, the effects of hostility, impulsiveness, extraversion-activity, openness to ideas, competence, and self-discipline are mediated by the effects of sufficiency of income and self-rated health. Among women who noted the changes in the recommendations, decisions among this well-educated group of women were predicted by their personal risk of breast cancer. In addition, those higher in achievement striving were less likely to change their intention to have regular mammograms.
