***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Objective - To examine the psychological consequences at a number of stages in the screening process for women attending a screening mammography programme . Setting - A pilot mammographic screening programme in Melbourne , Australia . Method — The psychological consequences question naire ( PCQ ; a reliable and valid measure of the psychological consequences of screening mammography ) was used to measure the emotional , social , and physical functioning of women in a mammographic screening programme and a control community sample . A screening group ( in whom no abnormality was detected at initial screen ; n=142 ) had four measurements : at screening clinic ; before results were received ; one week after all-clear results were received ; and eight months after initial visit . The recall group ( who were recalled for further investigation which showed the detected abnormality to be benign ; n = 58 ) had measurements at the same points as the screening group and an additional measurement while waiting at the recall assessment clinic . A r and omly selected community control group ( n = 52 ) had measurements one week , two weeks , three weeks ; and eight months after consenting to participate . Results - Emotional , social , and physical functioning of women in the screening group did not change over time and at no point differed significantly from that of community controls . The profiles of emotional and physical dysfunction of women in the recall group differed significantly from those of the screening and control groups . The level of emotional and physical dysfunction in the recall group was highest while waiting at recall assessment clinic , and scores were still significantly higher than scores obtained at comparable times from screening and control groups one week after obtaining notification that there was no sign of cancer ( emotional P < 0·001 ; physical P < 0·05 ) . This difference had disappeared eight months after the screening visit , when the level of emotional and physical functioning was similar to that of the screening and control groups . Social dysfunction scores did not change significantly over time and were similar for all three groups . Conclusions - Given that up to 10 % of women are recalled for further investigations on first round screening , significant numbers of women may have psychological consequences . This speaks for the necessity for accurate reading of mammograms to minimise the false positive recall rate , and for counselling services to be available at recall assessment centres BACKGROUND Few studies have evaluated interventions to decrease a woman 's anxiety after she receives an abnormal mammogram ( i.e. , one with a recommendation for follow-up ) . We performed a controlled trial to compare the effects of both an immediate reading of mammograms ( i.e. , a radiology intervention ) and of an educational intervention that taught skills to cope with anxiety on the psychological status of women whose mammograms were normal or abnormal . METHODS Eligible women ( n = 8543 ) aged 39 years or older were recruited from seven mammography sites at the time of their scheduled mammography screening and assigned to receive no intervention , either the radiology or the educational intervention , or both interventions . We used the Impact of Events Scale ( IES ) and the Hopkins Symptom Checklist subscales for Anxiety ( HSC-A ) and Depression ( HSC-D ) in structured telephone interviews of 2844 women to assess the psychological status of all women with abnormal mammograms ( excluding women diagnosed with breast cancer ) and of a r and om sample of women with normal mammograms at 3 weeks and 3 months after their mammograms . All statistical tests were two-sided . RESULTS We obtained usable 3-week interviews for 2390 ( 84 % ) women . By the 3-week interview , 1037 ( 72.1 % ) of the 1439 interviewed women with abnormal mammograms had completed the recommended work-up and knew that their abnormal mammograms were false positives . Women with abnormal mammograms had higher IES and HSC-A scores ( i.e. , more anxiety ) than women with normal mammograms ( mean IES scores : 4.97 [ 95 % confidence interval [ CI ] = 4.47 to 5.50 ] and 1.82 [ 95 % CI = 1.51 to 2.14 ] , respectively ; P<.001 ; mean HSC-A scores : 1.14 [ 95 % CI = 1.12 to 1.15 ] and 1.11 [ 95 % CI = 1.09 to 1.13 ] , respectively , P=.002 ) . Among women with false-positive mammograms , those who had received the radiology intervention reported less anxiety than those who had not ( mean IES scores : 4.42 [ 95 % CI = 3.73 to 5.07 ] and 5.53 [ 95 % CI = 4.82 to 6.28 ] , respectively , P=.026 ) . The educational intervention was not associated with any difference in psychological outcomes . Three months after the mammogram , by which time more than 80 % of the women with abnormal results knew their mammograms to be false positives , anxiety levels of women with false-positive mammograms remained higher than those of women with normal mammograms ( mean IES scores : 2.34 [ 95 % CI = 1.99 to 2.69 ] and 1.15 [ 95 % CI = 0.87 to 1.47 ] , respectively , P<.001 ) . CONCLUSION Immediate reading of screening mammograms , but not an educational intervention targeting coping skills , was associated with less anxiety among women with false-positive mammograms 3 weeks after mammography Objective : There is consistent evidence that alcohol increases the risk of breast cancer .  It has been suggested that the increased risk associated with alcohol intake may be reduced by adequate intake of folate . Since many women consume alcohol , detection of a risk-reducing mechanism would have major public health implication s. Design : We therefore evaluated the possible interaction between alcohol and folate in a paired nested case – control study among postmenopausal women . Setting : A total of 24 697 postmenopausal women were included in the ‘ Diet , Cancer and Health ’ follow-up study between December 1993 and May 1997 . The cohort was followed until December 2000 . The study included 388 cases of breast cancer and 388 r and omly selected controls were used to estimate the breast cancer incidence rate ratio ( IRR ) in conditional logistic regression analysis . Results : A previously established association between alcohol intake and risk of breast cancer was present mainly among women with low folate intake . An IRR of 1.19 ( 95 % CI : 0.99–1.42 ) per 10 g average daily alcohol intake was found for women with a daily folate intake below 300 μg , while among women with a folate intake higher than 350 μg , we could not show an association between the alcohol intake and the breast cancer incidence rate ( e.g. folate intake > 400 μg ; IRR of 1.01 ( 95 % CI : 0.85–1.20 ) ) . Conclusion : The findings support the evidence that adequate folate intake may attenuate the risk of breast cancer associated with high alcohol intake . Sponsorship : The Danish Cancer Society The aim was to investigate the psychological consequences of further investigation after breast cancer screening . Study participants include 509 women ( 61 % ) recalled due to suspicious findings on screening mammograms , and a matched control group of 285 women ( 68 % ) with normal mammograms .  Psychological distress was prospect ively assessed with the Hospital Anxiety and Depression Scale ( HADS ) . 46 % of the women reported borderline or clinical ly significant anxiety prior to the recall visit . A few days after the visit , anxiety and depression had decreased significantly ( P<0.01 ) in women informed about normal or benign results at the recall clinic , while reported distress remained at relatively high levels in women referred to surgical biopsy . The results demonstrate the adverse short-term effect of a delay in receiving false-positive results , but do not indicate that the recall experience results in long-term anxiety or depression for a majority of women Objective To study psychosocial predictors of attendance at an  organised breast cancer screening programme .  Setting  Finnish screening programme  based on  personal first round invitations in 1992–94 , and with 90 % attendance rate . Methods Attenders ( n=946 ) belonged to a 10 % r and om sample ( n=1680 women , age 50 , response rate 64 % ) of the target population ( n=16 886 ) , non-attenders ( n=641 , 38 % ) came from the whole target population . Predictors were measured one month before the screening invitation . Measures included items for social and behavioural factors , Breast Cancer Susceptibility Scale , Illness Attitude Scale , Health Locus of Control Scale , Anxiety Inventory , and Depression Inventory . Univariate and multivariate logistic regression analyses were used to predict attendance . Results Those most likely to attend were working , middle income , and averagely educated women , who had not had a mass mammogram recently , but who regularly visited gynaecologists , attended for Pap smear screening , practised breast self examination , and who did not smoke . Low confidence in their own capabilities in breast cancer prevention , overoptimism about the sensitivity of mammography , and perception of breast cancer risk as moderate were also predictive of attendance . Expectation of pain at mammography was predictive of non-attendance . Conclusion Mammography screening organised as a public health service was well accepted . A recent mammogram , high reliance on self control of breast cancer , and an expectation of pain at mammography deterred attendance at screening . Further information about these factors and health information on screening are needed AIMS A r and omized trial investigated the impact of risk-tailored messages on mammography in diverse women in the Virginia Commonwealth University Health System 's gynecology clinics . METHODS From 2003 to 2005 , 899 patients > or = 40 years of age were r and omized to receive risk-tailored information or general information about breast health . Multiple logistic regression analyses summarize their breast health practice s at 18 months . RESULTS At baseline , 576 ( 64 % ) women reported having a mammogram in the past year . At 18-month follow-up , mammography rates were 72.6 % in the intervention group and 74.2 % in the control group ( N.S. ) . Women ( n = 123 ) who reported worrying about breast cancer " often " or " all the time " had significantly higher mammography rates with the intervention ( 85.0 % ) vs. the controls ( 63.5 % ) . No significant differences existed in clinical breast examination , self-examination , or mammography intentions between the two study arms . However , intervention women with lower education reported significantly fewer clinical breast examinations at follow-up . CONCLUSIONS The brief intervention with a risk-tailored message did not have a significant effect overall on screening at 18 months . However , among those who worried , mammography rates in the intervention group were higher . Individual characteristics , such as worry about breast cancer and education status , may impact interventions to improve breast cancer prevention practice Summary of the Recommendations The U.S. Preventive Services Task Force ( USPSTF ) recommends screening mammography , with or without clinical breast examination ( CBE ) , every 1 to 2 years for women aged 40 and older . This is a grade B recommendation . ( See Appendix Table 1 for a description of the USPSTF classification of recommendations . ) The USPSTF found fair evidence that mammography screening every 12 to 33 months significantly reduces mortality from breast cancer . ( See Appendix Table 2 for a description of the USPSTF classification of levels of evidence . ) Evidence is strongest for women aged 50 to 69 , the age group generally included in screening trials . For women aged 40 to 49 , the evidence that screening mammography reduces mortality from breast cancer is weaker , and the absolute benefit of mammography is smaller , than it is for older women . Most , but not all , studies indicate a mortality benefit for women undergoing mammography at ages 40 to 49 , but the delay in observed benefit in women younger than 50 makes it difficult to determine the incremental benefit of beginning screening at age 40 rather than at age 50 . The absolute benefit is smaller because the incidence of breast cancer is lower among women in their 40s than it is among older women . The USPSTF concluded that the evidence is also generalizable to women aged 70 and older ( who face a higher absolute risk of breast cancer ) if their life expectancy is not compromised by comorbid disease . The absolute probability of benefits of regular mammography  increases along a continuum with age , whereas the likelihood of harms from screening ( false-positive results and unnecessary anxiety , biopsies , and cost ) diminishes from ages 40 to 70 . The balance of benefits and potential harms , therefore , grows more favorable as women age . The precise age at which the potential benefits of mammography justify the possible harms is a subjective choice . The USPSTF did not find sufficient evidence to specify the optimal screening interval for women aged 40 to 49 ( see Clinical Considerations ) . The USPSTF concludes that the evidence is insufficient to recommend for or against routine CBE alone to screen for breast cancer . This is a grade I recommendation . No screening trial has examined the benefits of CBE alone ( without accompanying mammography ) compared to no screening , and design characteristics limit the generalizability of studies that have examined CBE . The USPSTF could not determine the benefits of CBE alone or the incremental benefit of adding CBE to mammography . The USPSTF therefore could not determine whether potential benefits of routine CBE outweigh the potential harms . The USPSTF concludes that the evidence is insufficient to recommend for or against teaching or performing routine breast self-examination ( BSE ) . This is a grade I recommendation . The USPSTF found poor evidence to determine whether BSE reduces breast cancer mortality . The USPST 
    Output:
    
BC worry in FE of breast screening was associated with several sociodemographic and psychosocial factors of recalled women , as well as those related to the FE process .
The review gave implication s for interventions in the FE process of mammography screening .