Introduction/Objective: To explore women's knowledge and expectations of the accuracy of mammographic screening, and to explore their attitudes towards compensation for missed or delayed diagnoses of breast cancer.

Methods: Cross-sectional study consisting of a telephone survey of women aged 30-69 years selected at random across Australia (N=115).

Results: Forty percent of women correctly answered that the sensitivity of mammographic screening actually lies in the range 75-99%. Only 5% of women thought the sensitivity of screening mammography is currently 100%, that is that screening mammography currently detects all cancers. In contrast, almost half the women thought that screening mammography should pick up all cancers (100% sensitivity), and almost 80% thought the sensitivity should be over 80%. Nevertheless, women were prepared to accept much lower sensitivities before deciding that screening would not be worthwhile: only 14% of women said all cancers should be detected in order for screening to be worthwhile, while most women considered that screening would be worthwhile if sensitivities were between 50% and 99%. About 40% of women reported that financial compensation should be paid to a woman if her breast cancer is missed by screening mammography due to the small failure rate of the test (that is, that sensitivity is not 100%). However, if the cancer is missed because of a negligent error made by someone in the screening process, 94% of women thought compensation should be paid.

Discussion: Recent successful legal action for missed diagnoses and subsequent compensation pay-outs threaten to make publicly funded mammographic screening non-viable. These results suggest women may be taking legal action because of their expectation that mammographic screening should have very high, or even perfect accuracy and may provide some options for improving the current situation.