将风险分层筛查引入国民保健制度乳房筛查计划：英国-巴基斯坦裔妇女的观点。
The introduction of risk stratified screening into the NHS breast screening Programme: views from British-Pakistani women.
机构信息
Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Room 1.13, Coupland 1, Coupland Street, Off Oxford Road, Manchester, M13 9PL, UK.
Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust (MFT), Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK.
出版信息
BMC Cancer. 2020 May 20;20(1):452. doi: 10.1186/s12885-020-06959-2.
BACKGROUND
UK national guidelines suggest women at high-risk of breast cancer should be offered more frequent screening or preventative medications. Currently, only 1 in 6 high-risk women are identified. One route to identify more high-risk women is via multifactorial risk assessment as part of the UK's NHS Breast Screening Programme (NHSBSP). As lower socioeconomic and minority ethnic populations continue to experience barriers to screening, it is important that any new service does not exacerbate issues further. To inform service development, this study explored views of women from underserved backgrounds regarding the introduction of risk stratification into the NHSBSP.
METHODS
Nineteen semi-structured interviews were conducted with British-Pakistani women from low socioeconomic backgrounds from East Lancashire, UK. Fourteen interviews were conducted via an interpreter.
RESULTS
Thematic analysis produced three themes. Attitudes toward risk awareness concerns the positive views women have toward the idea of receiving personalised breast cancer risk information. Anticipated barriers to accessibility emphasises the difficulties associated with women's limited English skills for accessing information, and their I.T proficiency for completing an online risk assessment questionnaire. Acceptability of risk communication strategy highlights the diversity of opinion regarding the suitability of receiving risk results via letter, with the option for support from a healthcare professional deemed essential.
CONCLUSIONS
The idea of risk stratification was favourable amongst this underserved community. To avoid exacerbating inequities, this new service should provide information in multiple languages and modalities and offer women the opportunity to speak to a healthcare professional about risk. This service should also enable completion of personal risk information via paper questionnaires, as well as online.
背景
英国国家指南建议对乳腺癌高危女性应提供更频繁的筛查或预防性药物。目前，只有 1/6 的高危女性被识别出来。通过多因素风险评估来识别更多高危女性的途径之一是作为英国国民保健制度乳房筛查计划（NHSBSP）的一部分。由于较低社会经济和少数族裔群体继续面临筛查障碍，因此任何新服务都不应进一步加剧这些问题。为了为服务开发提供信息，本研究探讨了服务背景下的女性对将风险分层引入 NHSBSP 的看法。
方法
对来自英国东兰开夏的英裔巴基斯坦裔低收入背景的 19 名女性进行了 19 次半结构化访谈。其中 14 次访谈是通过口译进行的。
结果
主题分析产生了三个主题。对风险意识的态度关注的是女性对接受个性化乳腺癌风险信息的想法的积极看法。可及性预期障碍强调了女性有限的英语技能获取信息的困难，以及她们完成在线风险评估问卷的 IT 熟练程度。风险沟通策略的可接受性突出了关于通过信件接收风险结果的适宜性的不同意见，认为从医疗保健专业人员那里获得支持是必不可少的。
结论
分层风险的想法在这个服务不足的社区中是受欢迎的。为了避免加剧不平等，这项新服务应提供多种语言和模式的信息，并为女性提供与医疗保健专业人员讨论风险的机会。该服务还应允许通过纸质问卷以及在线方式完成个人风险信息。
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