Wegwarth Odette, Widschwendter Martin, Cibula David, Sundström Karin, Portuesi Rosalba, Lein Ines, Rebitschek Felix G
Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany.
Harding Center for Risk Literacy, Max Planck Institute for Human Development, Berlin, Germany.
BMJ Open. 2018 Dec 28;8(12):e023789. doi: 10.1136/bmjopen-2018-023789.
Informed decisions about cancer screening require accurate knowledge regarding cancer risks and screening. This study investigates: (1) European women's knowledge of their risk of developing breast, ovarian, cervical or endometrial cancer, (2) their knowledge about mammography screening and (3) whether an evidence-based leaflet improves their knowledge.
Cross-sectional online intervention survey.
National samples from five European countries (Czech Republic, Germany, UK, Italy and Sweden)-drawn from the Harris Interactive and the Toluna panel, respectively, in January 2017-were queried on their knowledge of age-specific risks of developing breast, cervical, ovarian or endometrial cancer within the next 10 years and of mammography screening before and after intervention.
Of 3629 women (inclusion criteria: age 40-75 years) invited, 2092 responded and 1675 completed the survey (response rate: 61.4%).
Evidence-based leaflet summarising information on age-adjusted female cancer risks, mammography and aspects of cancer prevention.
Proportion of women (1) accurately estimating their risk of four female cancers, (2) holding correct assumptions of mammography screening and (3) changing their estimations and assumptions after exposure to leaflet.
Across countries, 59.2% (95% CI 56.8% to 61.6%) to 91.8% (95% CI 90.3% to 93.0%) overestimated their female cancer risks 7-33 fold (medians: 50.0 to 200.0). 26.5% (95% CI 24.4% to 28.7%) were aware that mammography screening has both benefits and harms. Women who accurately estimated their breast cancer risk were less likely to believe that mammography prevents cancer (p<0.001). After leaflet intervention, knowledge of cancer risks improved by 27.0 (95% CI 24.9 to 29.2) to 37.1 (95% CI 34.8 to 39.4) percentage points and of mammography by 23.0 (95% CI 21.0 to 25.1) percentage points.
A considerable number of women in five European countries may not possess the prerequisites for an informed choice on cancer screening. Evidence-based information in patient leaflets can improve this situation.
关于癌症筛查的明智决策需要对癌症风险和筛查有准确的了解。本研究调查：（1）欧洲女性对患乳腺癌、卵巢癌、宫颈癌或子宫内膜癌风险的了解，（2）她们对乳腺钼靶筛查的了解，以及（3）一份循证宣传册是否能提高她们的认知。
横断面在线干预调查。
2017年1月分别从哈里斯互动调查公司和托卢纳调查小组抽取的来自五个欧洲国家（捷克共和国、德国、英国、意大利和瑞典）的全国样本，被询问其对未来10年内患乳腺癌、宫颈癌、卵巢癌或子宫内膜癌的特定年龄风险以及干预前后乳腺钼靶筛查的了解。
在邀请的3629名女性（纳入标准：年龄40 - 75岁）中，2092人做出回应，1675人完成调查（回应率：61.4%）。
一份循证宣传册，总结了关于年龄调整后的女性癌症风险、乳腺钼靶检查及癌症预防方面的信息。
女性（1）准确估计其患四种女性癌症风险的比例，（2）对乳腺钼靶筛查持有正确认知的比例，以及（3）接触宣传册后其估计和认知的变化情况。
在各个国家，59.2%（95%置信区间56.8%至61.6%）至91.8%（95%置信区间90.3%至93.0%）的女性高估其女性癌症风险7至33倍（中位数：50.0至200.0）。26.5%（95%置信区间24.4%至28.7%）的女性意识到乳腺钼靶筛查既有益处也有危害。准确估计其乳腺癌风险的女性不太可能认为乳腺钼靶检查能预防癌症（p<0.001）。在宣传册干预后，癌症风险知识提高了27.0（95%置信区间24.9至29.2）至37.1（95%置信区间34.8至39.4）个百分点，乳腺钼靶筛查知识提高了23.0（95%置信区间21.0至25.1）个百分点。
五个欧洲国家中有相当数量的女性可能不具备对癌症筛查做出明智选择的前提条件。患者宣传册中的循证信息可以改善这种情况。
