Radboud Institute for Health Sciences, Radboud university medical center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Alfred, Nobels allé 23, 23300, 14183, Huddinge, Sweden.
BMC Cancer. 2020 Mar 24;20(1):247. doi: 10.1186/s12885-020-06745-0.
Increased knowledge of breast cancer risk factors has meant that we are currently exploring risk-based screening, i.e. determining screening strategies based on women's varying levels of risk. This also enables risk management through primary prevention strategies, e.g. a lifestyle programme or risk-reducing medication. However, future implementation of risk-based screening and prevention will warrant significant changes in current practice and policy. The present study explores women's perceptions of the implementation and organisation of risk-based breast cancer screening and prevention to optimise acceptability and uptake.
A total of 143 women eligible for breast cancer screening in the Netherlands, the United Kingdom, and Sweden participated in focus group discussions. The focus group discussions were transcribed verbatim and the qualitative data was analysed using thematic analysis.
Women from all three countries generally agreed on the overall proceedings, e.g. a risk assessment after which the risk estimate is communicated via letter (for below average and average risk) or consultation (for moderate and high risk). However, discrepancies in information needs, preferred risk communication format and risk counselling professional were identified between countries. Additionally, a need to educate healthcare professionals on all aspects of the risk-based screening and prevention programme was established.
Women's insights identified the need for country-specific standardised protocols regarding the assessment and communication of risk, and the provision of heterogeneous screening and prevention recommendations, monitoring the principle of solidarity in healthcare policy.
随着对乳腺癌危险因素认识的不断提高，我们目前正在探索基于风险的筛查，即根据女性不同的风险水平确定筛查策略。这也使得通过初级预防策略（如生活方式计划或降低风险的药物）进行风险管理成为可能。然而，未来实施基于风险的筛查和预防将需要对当前的实践和政策进行重大改变。本研究旨在探讨女性对基于风险的乳腺癌筛查和预防实施和组织的看法，以优化可接受性和参与度。
共有 143 名来自荷兰、英国和瑞典的符合乳腺癌筛查条件的女性参加了焦点小组讨论。焦点小组讨论的内容逐字记录下来，使用主题分析对定性数据进行分析。
来自所有三个国家的女性总体上都同意大致的程序，例如在风险评估之后，通过信件（对于低风险和平均风险）或咨询（对于中风险和高风险）来传达风险估计。然而，各国之间在信息需求、首选的风险沟通格式和风险咨询专业人员方面存在差异。此外，还需要对医疗保健专业人员进行关于基于风险的筛查和预防计划的所有方面的教育。
女性的观点确定了需要针对风险评估和沟通制定特定于国家的标准化协议，并提供异质的筛查和预防建议，监测医疗保健政策中的团结原则。
