Differential appraisal of age thresholds for mammographic screening in Holland and Switzerland

Abstract

Introduction

Information campaigns on breast cancer screening need to convince women above 50 years of age to have biannual mammograms, and women below 50 years of age that regular mammograms are not recommended for them. Earlier experiments in the Netherlands showed that type of evidence (statistical vs. anecdotal) and message framing (gain vs. loss) had no effects on attitudes to breast cancer screening. It also emerged that screening was widely accepted for women above 50, but women were reluctant to accept the exclusion of women under 50 from routine screening, although many and good arguments for this were presented.

Aim

This study aims at finding out whether these results are specific to the Dutch culture by replicating the experiments in Ticino, Switzerland.

Methods

A leaflet, constructed for the purposes of the study and informing women about breast cancer screening, served as the experimental stimulus in a pre-post-test design.

Results

Findings show that in Ticino gain-framing appeared to be systematically more persuasive than loss-framing. Moreover, Ticino women were more willing than the Dutch to accept that women under the age threshold of 50 are not recommended routine mammography every 2 years. Borrowing from reactance theory, the higher acceptance of an age threshold in Ticino is explained by differences in the regulations. Lower attention to the issue there as well as the broader context of culturally tailored health communication also play a role.

Keywords:

• Age thresholds
• Anecdotal vs. statistical evidence
• Breast cancer
• Health communication mammographic screening
• Message framing effects

Additional information

Notes on contributors

Peter Schulz

Peter J. Schulz is a professor for communication theories and health communication at the Faculty of Communication Sciences and director of the Institute of Communication and Health at the Università della Svizzera italiana. He currently holds several research projects in the field of health communication, prevention, and health literacy.

Bert Meuffels

Bert Meuffels is a professor in the Department of Speech Communication, Argumentation Theory, and Rhetoric at the University of Amsterdam, specialized in methodological and statistical aspects of empirical research into speech communication. He currently holds several research projects in the field of communication and argumentation in health contexts.