“A Natural Progression”: Australian Women's Attitudes About an Individualized Breast Screening Model

Lippey, Jocelyn; Keogh, Louise; Mann, G. Bruce; Campbell, Ian; Forrest, Laura

doi:10.1158/1940-6207.capr-18-0443

Cited by 33 publications

(110 citation statements)

References 34 publications

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“…A recent quantitative survey found that only 57% of women surveyed in five European countries stated that they would consider less cancer screening if they were at lower than average genetic risk, 12 and qualitative research from Australia found that women feel a strong emotional connection to current methods of breast screening. 13 A relevant caveat to this finding is that a greater number of screening risks were presented compared with benefits. This is consistent with the existing NHS screening information leaflet, 4 have increased preferences for reduced-frequency (i.e.…”

Section: Discussionmentioning

confidence: 95%

Acceptability of risk-stratified breast screening: Effect of the order of presenting risk and benefit information

et al. 2019

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Objective To test whether reduced-frequency risk-stratified breast screening would be perceived more favourably by transposing the order of information on benefits and risks. Methods After reading vignettes describing non-stratified three-yearly screening and a risk-stratified alternative with five-yearly invitations for women at low risk, 698 women completed an online survey. Participants were allocated at random to information on screening benefits followed by risks, or vice versa, and asked to state preferences for either screening system. Participants also rated perceived magnitude of screening benefits and risks, and breast cancer susceptibility. Results Binomial logistic regression did not find order effects on preferences (p = 0.533) or perceived benefits of screening (p = 0.780). Perceived screening risks were greater when risks were presented first (p < 0.0005). Greater perceived susceptibility was associated with lower proportions preferring risk-stratified screening (15% vs. 39% in highest and lowest groups; p = 0.002), as were greater perceived screening benefits (e.g. 13% vs. 45% in highest and lowest groups; p < 0.0005). Conclusions No information order effect on preferences was observed. Information order did affect screening risk perceptions. Efforts to improve perceptions may need to be more intensive than those tested. Women perceiving themselves as high risk or perceiving greater benefits of screening may be particularly averse to less frequent screening.

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Section: Discussionmentioning

confidence: 95%

Acceptability of risk-stratified breast screening: Effect of the order of presenting risk and benefit information

et al. 2019

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“…A previous online survey found that 72% of women wanted to know their 10-year risk of breast cancer vs. only 65% for endometrial cancer, 19 and qualitative findings suggest that some women may be more accepting of longer intervals for cervical than breast screening. 11 This could be tested in future studies. We also assessed perceptions of one type of risk assessment (multifactorial).…”

Section: Discussionmentioning

confidence: 99%

“…In a sample of 52 women in Australia, participants saw advantages of a multifactorial approach, but had reservations around data security and motivations behind transitioning to this method. 11 There is also varied evidence on women's preferences for delivery of risk assessment results. Research from the United States suggests that women have mixed preferences for written (vs. face-to-face) information, and from primary care clinicians and genetic counsellors, 12,13 whereas participants in a study in Sweden found a consultation with a cancer specialist was most preferable.…”

Section: Introductionmentioning

confidence: 99%

Attitudes towards risk-stratified breast cancer screening among women in England: A cross-sectional survey

et al. 2019

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Objectives Risk stratification may improve the benefit/harm ratio of breast screening. Research on acceptability among potential invitees is necessary to guide implementation. We assessed women’s attitudes towards and willingness to undergo risk assessment and stratified screening. Methods Women in England aged 40–70 received summary information about the topic, and completed face-to-face computer-assisted interviews. Questions assessed willingness to undergo multifactorial breast cancer risk assessment, more frequent breast screening (if at very high risk), or less frequent or no screening (if at very low risk), and preferences for delivery of assessment results. Results Among 933 women, 85% considered breast cancer risk assessment a good idea, and 74% were willing to have it. Among 125 women unwilling to have risk assessment, reasons commonly related to ‘worry’ (14%) and ‘preferring not to know’ (14%). Among those willing to have risk assessment ( n = 689), letters/emails were generally preferred (42%) for results about very low-risk status. Face-to-face communication was most commonly preferred for results of very high-risk status (78%). General practitioners were most commonly preferred sources of assessment results (≈40%). Breast cancer specialists were often preferred for results of very high-risk status (38%). Risk-stratified breast screening was considered a good idea by 70% and 89% were willing to have more frequent screening. Fewer would accept less (51%) or no screening (37%) if at very low risk. Conclusions Women were generally in favour of multifactorial breast cancer risk assessment and risk-stratified screening. Some were unwilling to accept less or no screening if at very low risk.

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“…There is also a consensus that for risk-based screening to be successfully implemented as part of a population-based screening program, it has to be accepted and supported by stakeholders, particularly women undergoing BC screening [ 11 , 12 ]. Burgeoning evidence from studies conducted in the United Kingdom (UK), Sweden, Netherlands, and Australia [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ] indicates that women appear to welcome the prospect of risk-stratified BC screening.…”

Section: Introductionmentioning

confidence: 99%

Women’s Views on Multifactorial Breast Cancer Risk Assessment and Risk-Stratified Screening: A Population-Based Survey from Four Provinces in Canada

Bienge

Pashayan

Brooks

et al. 2021

JPM

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Risk-stratified screening for breast cancer (BC) is increasingly considered as a promising approach. However, its implementation is challenging and needs to be acceptable to women. We examined Canadian women’s attitudes towards, comfort level about, and willingness to take part in BC risk-stratified screening. We conducted an online survey in women aged 30 to 69 years in four Canadian provinces. In total, 4293 women completed the questionnaire (response rate of 63%). The majority of women (63.5% to 72.8%) expressed favorable attitudes towards BC risk-stratified screening. Most women reported that they would be comfortable providing personal and genetic information for BC risk assessment (61.5% to 67.4%) and showed a willingness to have their BC risk assessed if offered (74.8%). Most women (85.9%) would also accept an increase in screening frequency if they were at higher risk, but fewer (49.3%) would accept a reduction in screening frequency if they were at lower risk. There were few differences by province; however, outcomes varied by age, education level, marital status, income, perceived risk, history of BC, prior mammography, and history of genetic test for BC (all p ≤ 0.01). Risk-based BC screening using multifactorial risk assessment appears to be acceptable to most women. This suggests that the implementation of this approach is likely to be well-supported by Canadian women.

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“A Natural Progression”: Australian Women's Attitudes About an Individualized Breast Screening Model

Cited by 33 publications

References 34 publications

Acceptability of risk-stratified breast screening: Effect of the order of presenting risk and benefit information

Acceptability of risk-stratified breast screening: Effect of the order of presenting risk and benefit information

Attitudes towards risk-stratified breast cancer screening among women in England: A cross-sectional survey

Women’s Views on Multifactorial Breast Cancer Risk Assessment and Risk-Stratified Screening: A Population-Based Survey from Four Provinces in Canada

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