A number of states have enacted laws to provide letters to mammogram patients when it is determined they have dense breast tissue, to help them understand the risks of the condition and what they need to do to make sure they are cancer-free.

Unfortunately, a new study which reviewed many of the standard letters, published in the Journal of the American Medical Association, says some of them are so complicated, many of those receiving them may become more confused in the process.

The authors of the new study say the language used in some of the notifications is only understandable to readers with a college education, or medical professionals.  They point out that around twenty percent of the population in the United States reads at eighth-grade level, and there are many more that read at levels just above that.

Study co-author Nancy Kressin, from the Boston University School of Medicine, said many of the notifications are not going to be easy to read and may alarm some of the recipients.   She adds some women may react as if they were told they had cancer, when that was not the case.

Some women have dense breast tissue, a condition where the breast contains higher levels of fibrous and connective tissues, and it is not uncommon.  The issue with the condition is that it can mask some cancers during the mammogram procedure, and studies have also shown women with dense breasts are more likely to have breast cancer.

The intent was to inform women of the increased risk they face with the condition and to advise them to seek additional medical testing to be sure they are free from cancer.  The study says letters sent in New Jersey and Connecticut were only understandable by post graduates, as compared to the notification required in the state of Alabama, which could be understood by those reading at a seventh-grade level.

Many of the low-literacy group are among the poorer Americans and they are less likely to seek medical attention in the first place, so the letters may not be achieving their desired results.

Kressin adds even a few high-level words can make the material harder to understand, and can lead to anxiety and confusion among the readers.