Willingness to Participate in Mammography Screening

Gummersbach, Elisabeth; Schmitten, Jürgen in der; Mortsiefer, Achim; Abholz, Heinz-Harald; Wegscheider, Karl; Pentzek, Michael

doi:10.3238/arztebl.2015.0061

Cited by 18 publications

(12 citation statements)

References 30 publications

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“…Ten studies were excluded after full text assessment (see table A2.1 in online supplementary appendix 2 for details). Finally, three randomised controlled studies (Mathieu et al , 24 Gummersbach et al 20 and Hersch et al 11 ) and one before-after study (Eden et al 25 ) were selected. These four studies involved a total of 1650 participants from four countries (two from Australia, one each from Germany and the USA).…”

Section: Resultsmentioning

confidence: 99%

“…Hersch et al 11 was the only study free of a high risk of bias in all the domains assessed. Gummersbach et al 20 was rated as having a high risk of attrition bias due to a high level of non-response. Mathieu et al 24 was rated as having an unclear risk of allocation concealment and also of selective reporting.…”

Section: Resultsmentioning

confidence: 99%

“…In the Eden study, which assessed intraindividual changes, the DA was particularly useful for the least informed and least confident women. On the other hand, Gummersbach et al 20 noted that education level was positively associated with acquired knowledge and that the less educated women had less relevant decisional knowledge after reading the leaflet, but they were more willing to undergo mammography than more educated women. Only the Hersch study included a follow-up for final screening participation, but the results are not published yet.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of the effects of decision aids about breast cancer screening: a systematic review and meta-analysis

et al. 2017

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ObjectiveThe aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies is to assess the effect of decision aids (DAs) in women aged 50 and below facing the decision to be screened for breast cancer.SettingScreening for breast cancer.InterventionDAs aimed to help women make a deliberative choice regarding participation in mammography screening by providing information on the options and outcomes.Eligible studiesWe included published original, non-pilot, studies that assess the effect of DAs for breast cancer screening. We excluded the studies that evaluated only participation intention or actual uptake. The studies’ risk of bias was assessed with the Cochrane Collaboration’s tool for RCTs and the National Institutes of Health Quality Assessment Tool for non-RCTs.Primary and secondary outcomesThe main outcome measures were informed choice, decisional conflict and/or confidence, and knowledge. Secondary outcomes were values, attitudes, uncertainty and intention to be screened.ResultsA total of 607 studies were identified, but only 3 RCTs and 1 before-after study were selected. The use of DAs increased the proportion of women making an informed decision by 14%, 95% CI (2% to 27%) and the proportion of women with adequate knowledge by 12%, 95% CI (7% to 16%). We observed heterogeneity among the studies in confidence in the decision. The meta-analysis of the RCTs showed a significant decrease in confidence in the decision and in intention to be screened.ConclusionsTools to aid decision making in screening for breast cancer improve knowledge and promote informed decision; however, we found divergent results on decisional conflict and confidence in the decision. Under the current paradigm change, which favours informed choice rather than maximising uptake, more research is necessary for the improvement of DAs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Assessment of the effects of decision aids about breast cancer screening: a systematic review and meta-analysis

et al. 2017

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“…The possibility that fully informed patients may be less willing to undergo screening cannot justify providing them with inadequate information; moreover, no reliable data support this hypothesis. [ 22 – 24 ] We intended self-interest when the same occupational categories (rather than patients, scientists, etc.) both provide certain services and determine how useful the services are and who should receive them.…”

Section: Discussionmentioning

confidence: 99%

Scarce information about breast cancer screening

Attena

Cancellieri²,

Pelullo³

2016

Medicine

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“…The overall low proportion of informed choices is explained by the low level of knowledge about mammography screening in our sample. Poor knowledge about mammography screening has been shown previously: women tend to overestimate the benefits and underestimate the risks of mammography screening [ 17 , 18 , 25 ]. Our study even shows a lower proportion of correct answers as found in a randomized, controlled trial evaluation the German information leaflet sent with the official invitation for the program [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Informed Choice in the German Mammography Screening Program by Education and Migrant Status: Survey among First-Time Invitees

et al. 2015

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Breast cancer is the most prevalent cancer among women and mammography screening programs are seen as a key strategy to reduce breast cancer mortality. In Germany, women are invited to the population-based mammography screening program between ages 50 to 69. It is still discussed whether the benefits of mammography screening outweigh its harms. Therefore, the concept of informed choice comprising knowledge, attitude and intention has gained importance. The objective of this observational study was to assess the proportion of informed choices among women invited to the German mammography screening program for the first time. A representative sample of 17,349 women aged 50 years from a sub-region of North Rhine Westphalia was invited to participate in a postal survey. Turkish immigrant women were oversampled. The effects of education level and migration status on informed choice and its components were assessed. 5,847 (33.7%) women responded to the postal questionnaire of which 4,113 were used for analyses. 31.5% of the women had sufficient knowledge. The proportion of sufficient knowledge was lower among immigrants and among women with low education levels. The proportion of women making informed choices was low (27.1%), with similar associations with education level and migration status. Women of low (OR 2.75; 95% CI 2.18–3.46) and medium education level (OR 1.49; 95% CI 1.27–1.75) were more likely to make an uninformed choice than women of high education level. Turkish immigrant women had the greatest odds for making an uninformed choice (OR 5.30, 95% CI 1.92–14.66) compared to non-immigrant women. Other immigrant women only had slightly greater odds for making an uninformed choice than non-immigrant women. As immigrant populations and women with low education level have been shown to have poor knowledge, they need special attention in measures to increase knowledge and thus informed choices.

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Willingness to Participate in Mammography Screening

Cited by 18 publications

References 30 publications

Assessment of the effects of decision aids about breast cancer screening: a systematic review and meta-analysis

Assessment of the effects of decision aids about breast cancer screening: a systematic review and meta-analysis

Scarce information about breast cancer screening

Informed Choice in the German Mammography Screening Program by Education and Migrant Status: Survey among First-Time Invitees

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