Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada; Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
Health Policy. 2018 Dec;122(12):1364-1371. doi: 10.1016/j.healthpol.2018.09.013. Epub 2018 Sep 28.
Despite Canada's long history with mammography screening, little is known about citizens' perspectives about mammography and how best to support women to make informed choices about screening. To address this gap, a series of four citizen deliberation events were held in 2015-16 in Ontario, a Canadian province with an organized population-based breast screening program in place since 1990. Forty-nine individuals participated in four citizen panels, each comprising an information session highlighting the evidence about mammography, and large- and small-group deliberations about approaches to support informed decision making for screening. Following their engagement with the research evidence about mammography, participants expressed concern about their lack of full awareness of the risks and benefits and a strong desire for choice when it comes to screening. To support informed choice, mammography programs need to reflect the values of information sharing, trust and transparency, financial accountability, and allow for personal interactions and shared decision-making. Citizens are looking for balanced information about the risks and benefits of screening presented in an easy to understand, comprehensive, and transparent manner. Primary health care providers and organized screening programs are important sources of information about mammography and must be vigilant in their efforts to support informed decision-making in this area by ensuring that the information materials they are using are balanced and reflect current evidence.
尽管加拿大在乳房 X 光筛查方面有着悠久的历史，但对于公民对乳房 X 光筛查的看法以及如何最好地支持妇女做出明智的筛查选择，人们知之甚少。为了弥补这一空白，2015-2016 年在安大略省举行了一系列四次公民审议活动，该省自 1990 年以来就有一个有组织的基于人群的乳房筛查计划。49 人参加了四个公民小组，每个小组都包括一个信息会议，重点介绍关于乳房 X 光检查的证据，以及关于支持筛查知情决策的大组和小组讨论。在接触到有关乳房 X 光检查的研究证据后，参与者对自己对风险和益处缺乏全面了解表示担忧，并强烈希望在筛查方面有选择的机会。为了支持知情选择，乳房 X 光检查计划需要反映信息共享、信任和透明度、财务问责制的价值观，并允许进行个人互动和共同决策。公民正在寻找关于筛查风险和益处的平衡信息，以易于理解、全面和透明的方式呈现。初级保健提供者和有组织的筛查计划是乳房 X 光检查信息的重要来源，必须警惕在这一领域支持知情决策的努力，确保他们使用的信息材料是平衡的，并反映当前的证据。
