Factors affecting physician adherence to breast cancer screening guidelines.

A one-group, meta-analytic design was used to assess survey results published between the years of 1985 and 1990 that measured adherence to the breast cancer screening guidelines by U.S. primary care physicians. The purpose of this analysis was twofold: 1) to systematically synthesize current literature to determine why primary care physicians do not adhere to the prescribed breast cancer screening guidelines; and 2) to determine what strategies and interventions would be most effective in increasing adherence to the guidelines. Factors associated with nonadherence to guidelines included cost concerns, patient worry and refusal, radiation risk, and lack of confidence in performing a clinical breast examination. Five factors were associated with increased adherence to guidelines. Effective interventions must address the specific concerns of physicians by specialty to mitigate barriers to adherence. Generic interventions with a single focus are not likely to achieve their intended effects.