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(Siemens Medical Solutions)

Mammography More Stressful for Breast Cancer Survivors

The stress of mammography after surviving breast cancer may cause health risks beyond having a history of the disease itself, a new study suggests. Breast cancer survivors find follow-up mammography more stressful than do women who have never had the disease, or even those who are newly diagnosed, the researchers say.

"Women with a previous cancer diagnosis reported two to four times as many acute stress symptoms as women with no previous cancer," says Maria Gurevich, PhD, of Toronto's Ryerson University and Princess Margaret Hospital.

The study appears in a recent issue of the journal Psychosomatic Medicine.

Psychological stress may result from any aspect of mammography, Gurevich says, arising before screening, at the time of the test itself, while awaiting results or after hearing the outcome.

Such stress may influence future health. Memories of their earlier cancer diagnosis may affect survivors' willingness to return for regular follow-up mammograms or find them more stressful when they do go.

Some avoid these checkups altogether, even though the American Society of Clinical Oncology recommends annual mammograms for survivors of breast cancer. Earlier studies showed that 30 percent of survivors had not received a mammogram in the prior year.

"This raises the question of why women may be reluctant to undergo regular follow-up mammograms," Gurevich says. "Our study suggests that perhaps the experience triggers distressing memories of prior cancers."

Gurevich and colleagues assessed 135 women undergoing mammography at a large cancer center in Toronto. Sixty-six women had survived breast cancer earlier, while the other 69 women never had the disease. The mammograms for this study revealed that all 135 women were free of cancer. The women answered questions about stress levels, trauma history, psychiatric history, social support and physician support.

The study confirmed that even routine follow-up care and good mammography results could still trigger anxiety by recalling earlier bouts with cancer, Gurevich says.

"Survivors of breast cancer may experience heightened cancer-related fears, even after they have received negative mammography results," she says.

Having already lived for an average of 6.5 years after their first experience with breast cancer, two-thirds of these women could expect a favorable outcome. Nevertheless, these cancer survivors scored even higher on tests of acute stress than women who were newly diagnosed with breast cancer, Gurevich says, comparing her results with an earlier study.

"The experience of previous cancer may have a persistent influence on health-related threats and events," she says, "even in the absence of recurring disease."

The study also pointed out the role that physicians play in the connection between stress and mammography. Strong support from their physicians was associated with lower rates of stress for women who had never had cancer, but not for the cancer survivors.

"Among women with previous cancer, greater perceived physician support was associated with higher stress-related symptom levels," Gurevich says. This association did not mean that physicians caused their patients' symptoms, but rather that the patients' distress stimulated the physicians' concern.

Increased stress responses for the women were also associated with pre-mammography breast complaints, lower income, previous psychiatric medication use and greater sensitivity to physical sensations not related to illness.

For more information, call 202-387-2829 or visit www.hbns.org.

— Health Behavior News Service

Healthcare Costs Tops Americans' List of Concerns

Forty-one percent of Americans say their greatest hospital healthcare concern is cost, while 25 percent cite quality of care. This and other consumer attitudes and concerns about healthcare were released from a survey commissioned by Siemens Medical Solutions, Malvern, Pa.

The survey was conducted among a sample of more than 2,000 Americans who were either hospitalized or responsible for assisting in the admittance of another person to the hospital within the last five years.

"In an environment where the costs of healthcare are increasingly passed on to the consumer, it is not surprising that a high percentage of respondents selected cost over quality as their biggest concern with hospital healthcare," says Erich R. Reinhardt, PhD, president and CEO of Siemens Medical Solutions worldwide. "Reducing the cost of healthcare is of utmost concern to many Americans – and creating a sense of urgency among lawmakers. However, the desired decrease in healthcare costs requires a fundamental change, namely simplification of complexities through a standardized information infrastructure that in turn lessens the administrative burden placed on providers."

Along with highlighting Americans' growing concerns regarding the costs and quality of healthcare, the survey also revealed that 43 percent of respondents blame medical errors on overworked staff or staff shortages.

Three in 10 of those surveyed cite lack of communication among hospital departments as the second largest cause of medical errors.

Sixty-three percent of survey respondents agreed it would be "very valuable" to have their complete medical history stored electronically in one computer file that can be accessed anywhere in a hospital. Among other information technology solutions, Siemens currently offers electronic health record (EHR) and computerized physician order entry systems that provide caregivers with timely, accurate decision-making abilities that can have life-saving implications.

Consumers surveyed are eager to see EHRs better utilized. In fact, 26 percent believe EHRs are already available to them, and an additional 46 percent indicate they believe EHRs will be implemented for admissions and usage at their local hospitals within the next five years. Although consumers want to see EHRs implemented, nearly 58 percent of those surveyed are concerned about the privacy of their medical records.

The Siemens healthcare survey also confirmed that the attitudes of Americans 65 and older differ from younger audiences when it comes to trust that their physicians have complete information on their medical histories.

Interestingly, while nearly one-fifth of those surveyed did not think their physician has all the necessary and important information regarding their medical history, 89 percent of those over age 65 believe their physician has all the necessary and important information about their history.

For more information, call 610-219-6300 or visit www.usa.siemens.com/medical.

— Siemens Medical Solutions

Editor's Note: Due to a reporting error, in the article "Putting the Rad in Radiology" (Feb. 2, vol. 17, no. 5), Roland Rhynus was mistakenly identified as the vice president of operations for InSight Health Services, Lake Forrest, Calif. Mr. Rhynus should have been listed as an employee of Valley Radiology Consultants, Loma Linda, Calif.