Ballesteros-Peña Sendoa, Gavilán-Moral Enrique
Facultad de Medicina y Enfermería Universidad del País Vasco (UPV/EHU). Leioa. Bizkaia. España.
Unidad de Docencia e Investigación de Enfermería de la OSI Bilbao Basurto. Bilbao. Bizkaia. España.
Rev Esp Salud Publica. 2018 Oct 29;92:e201810076.
There are several methods to promote informed decision making before undergoing a screening program. This research aimed to analyze the contents of official documents about breast cancer screening programs.
A descriptive research was performed. After a literature review an agreed checklist was performed with the information needed to make decisions about participation in mammography screening programs. Informative documents about mammography screening valid in Spain in 2016 were analyzed by two independent researchers. The inter-rater agreement was verified and the discrepancies were solved by consensus. Absolute and relative frequencies of each item were calculated.
8 invitations and 14 citation letters, 12 leaflets, 8 brochures and 14 websites, from 18 screening programs, were reviewed. The information turned out to be very different according to each program. Only a third warned that participation is voluntary. 8 programs (44.4%) offered information on what is breast cancer and 7 (38.9%) on the cumulative risk of developing the disease. 15 (83.3%) explained the objectives of the program and 14 (77.8%) explained what mammography is. 14 programs (77.8%) presented as screening benefits the least invasive treatments, 12 the increase in survival (66.7%) and 10 the decrease in specific mortality (55.6%). Most of the programs did not report the possibility of false positives (27.8%) or false negatives (38.9%). Only 7 (38.9%) mentioned the possibility of overdiagnosis and 6 (33.3%) of overtreatment.
The information provided by the different breast cancer screening programs is variable and does not contain sufficient information for informed decision-making.
在进行筛查项目之前，有多种方法可促进知情决策。本研究旨在分析有关乳腺癌筛查项目的官方文件内容。
进行描述性研究。在文献综述之后，制定了一份商定的清单，其中包含参与乳房X光筛查项目决策所需的信息。两名独立研究人员对2016年在西班牙有效的有关乳房X光筛查的信息文件进行了分析。验证了评分者间的一致性，并通过共识解决了差异。计算了每个项目的绝对频率和相对频率。
审查了来自18个筛查项目的8份邀请函、14封引用信、12份传单、8份手册和14个网站。结果发现，每个项目提供的信息差异很大。只有三分之一的项目提醒参与是自愿的。8个项目（44.4%）提供了关于什么是乳腺癌的信息，7个项目（38.9%）提供了患该病的累积风险信息。15个项目（83.3%）解释了项目目标，14个项目（77.8%）解释了乳房X光检查是什么。14个项目（77.8%）将侵入性最小的治疗作为筛查益处，12个项目（66.7%）将生存率提高作为筛查益处，10个项目（55.6%）将特定死亡率降低作为筛查益处。大多数项目未报告假阳性（27.8%）或假阴性（38.9%）的可能性。只有7个项目（38.9%）提到了过度诊断的可能性，6个项目（33.3%）提到了过度治疗的可能性。
不同乳腺癌筛查项目提供的信息各不相同，且不包含足够的信息以供做出知情决策。
