Online information about risks and benefits of screening mammography in 10 European countries

Spagnoli, Laura; Navaro, Monica; Ferrara, Pietro; Prete, V. del; Attena, Francesco

doi:10.1097/md.0000000000010957

Cited by 10 publications

(8 citation statements)

References 33 publications

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“…The persistent lack of information is also a common finding in other countries, both from the website search [ 8 , 24 – 27 ] and written documents [ 9 , 28 – 30 ]. This seems surprising because overcoming the paternalistic physician–patient relationship has long been universally accepted and, in our case, because the scientific literature has continued over the years to emphasise the importance of an informed choice for women [ 12 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

Online information about mammography screening in Italy from 2014 to 2021

2022

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Background Many studies have reported that the information women receive about the risk-to-benefit ratio of breast cancer screening is still scarce and biased toward benefit. In a study we conducted in 2014, we analysed online documents about breast cancer screening that were addressed to the general female public. In the present study, we used the same methodology to verify if the information provided to women was improved. Methods We evaluated documents addressed to the general female public and posted on the Internet by the Italian national and regional public health services. False-positive and false-negative screening results, biopsy-proven false-positive results, interval cancer, overdiagnosis, radiation exposure, and decrease in risk of mortality were analysed. In addition, quantitative data were searched. Results In 2021, the most frequently reported information was reduction in breast cancer mortality (58.2%). The most frequently reported risk was a false-positive mammogram (42.5%). Similar frequency rates were reported for interval cancer, false-negative result, and radiation exposure (35.8%, 31.3%, and 28.3%, respectively). Overdiagnosis and biopsy-proven false-positive result were the less reported risks (20.1% and 10.4%). Thirteen documents provided quantitative data about reduction of mortality risk (16.7%), and only 19 provided quantitative data about risks or harms (8.4%). Almost all organisations sent letters of invitation to women (92.5%) and provided screening free of charge (92.5%). The most recommended was biennial screening for women aged between 50 and 69 years (48.5%). Compared with the information in 2014, that in 2021 showed some improvements. The most marked improvements were in the numbers of reports on overdiagnosis, which increased from 8.0 to 20.1%, and biopsy-proven false-positive result, which increased from 1.4 to 10.4%. Regarding the benefits of breast cancer screening, reduced mortality risk became increasingly reported from 2014 (34.5%) to 2021 (58.2%). Conversely, quantitative data remained scarce in 2021. Conclusions Moderate improvements in information were observed from 2014 to 2021. However, the information on breast cancer screening in documents intended for women published on Italian websites remain scarce.

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Section: Discussionmentioning

confidence: 99%

Online information about mammography screening in Italy from 2014 to 2021

2022

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“…The reduction in these infections concerns not only the possibility of avoiding a significant number of deaths but also their whole impact on health and health systems, averting disease cases and direct and social costs associated with cancer. Therefore, our findings might help primary care professionals and policymakers provide actionable metrics to adjust national and regional health care policies and enhance community health promotion for cancer prevention, screening, and care, through evidence-based information [ 39 , 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Estimates of Cancer Mortality Attributable to Carcinogenic Infections in Italy

Ferrara

Conti

Agüero

et al. 2020

IJERPH

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Several infectious agents are ascertained causes of cancer, but the burden of cancer mortality attributable to carcinogenic infections in Italy is still unknown. To tackle this issue, we calculated the rate and regional distribution of cancer deaths due to infections sustained by seven pathogens ranked as group 1 carcinogenic agents in humans by the International Agency for Research on Cancer. Population attributable fractions related to these agents were applied to annual statistics of cancer deaths coded according to the 10th International Classification of Diseases. The estimated burden of cancer mortality attributable to carcinogenic infections in Italy during the period 2011–2015 was 8.7% of all cancer deaths registered yearly, on average. Approximately 60% of deaths occurred in men, and almost the whole burden was due to four infectious agents (Helicobacter pylori, hepatitis C virus, high-risk human papillomavirus, and hepatitis B virus). The analysis of regional distribution showed a higher number of infection-related cancer deaths in the northern regions, where the estimates reached 30 (Liguria) and 28 (Friuli Venezia Giulia) deaths per 100,000 inhabitants in 2015. Since one-twelfth of cancer deaths were attributable to these modifiable risk factors, the implementation of appropriate prevention and treatment interventions may help to reduce the impact of these infections on cancer mortality.

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“…6 44 The scientific community agrees that people should be given better information about screening. 45 The fact that people with adequate knowledge of the overall benefit, false positive results, and overdiagnosis may be less likely to choose breast cancer screening, 41 and that those with an understanding of overdiagnosis may be more likely to express an intent to discontinue screening, further underlines this need. 46 Additional research, however, is needed to clarify how understanding affects longer term participation.…”

Section: Understanding Screening and Communicating Riskmentioning

confidence: 99%

Financial incentives for breast cancer screening undermine informed choice

Bartholomew

Colleoni²,

Schmidt

2022

BMJ

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Differences in estimates reflect the different screening periods, as well as methodological differences (including which trials are deemed sufficiently robust and unbiased). † Estimated that 3.36% of all women screened each year receive a false positive result. ‡ Estimated that the cumulative risk of a false positive result after 10 mammograms is around 20-60%. ¶ Concluded that the results are conflicting but that a false positive result can cause breast cancer specific psychological distress for up to three years. § Acknowledges that false positive results "can lead to psychological harms."

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Online information about risks and benefits of screening mammography in 10 European countries

Cited by 10 publications

References 33 publications

Online information about mammography screening in Italy from 2014 to 2021

Online information about mammography screening in Italy from 2014 to 2021

Estimates of Cancer Mortality Attributable to Carcinogenic Infections in Italy

Financial incentives for breast cancer screening undermine informed choice

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