Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Oxford Road, Manchester, M13 9PL, UK.
NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, England.
BMC Cancer. 2020 Jul 22;20(1):680. doi: 10.1186/s12885-020-07158-9.
There is international interest in risk-stratification of breast screening programmes to allow women at higher risk to benefit from more frequent screening and chemoprevention. Risk-stratification also identifies women at low-risk who could be screened less frequently, as the harms of breast screening may outweigh benefits for this group. The present research aimed to elicit the views of national healthcare policy decision-makers regarding implementation of less frequent screening intervals for women at low-risk.
Seventeen professionals were purposively recruited to ensure relevant professional group representation directly or indirectly associated with the UK National Screening Committee and National Institute for Health and Care Excellence (NICE) clinical guidelines. Interviews were analysed using thematic analysis.
Three themes are reported: (1) producing the evidence defining low-risk, describing requirements preceding implementation; (2) the impact of risk stratification on women is complicated, focusing on gaining acceptability from women; and (3) practically implementing a low-risk pathway, where feasibility questions are highlighted.
Overall, national healthcare policy decision-makers appear to believe that risk-stratified breast screening is acceptable, in principle. It will however be essential to address key obstacles prior to implementation in national programmes.
国际上对乳腺筛查项目进行风险分层很感兴趣，以便让高风险女性通过更频繁的筛查和化学预防获益。风险分层还可以识别低风险女性，对她们可以减少筛查频率，因为乳腺筛查的危害可能超过对该群体的益处。本研究旨在了解国家医疗保健政策决策者对低危女性实施更频繁筛查间隔的看法。
为确保直接或间接与英国国家筛查委员会和国家卫生与保健卓越研究所（NICE）临床指南相关的专业团体代表，特选择了 17 名专业人员进行有针对性的招募。使用主题分析对访谈进行分析。
报告了三个主题：（1）制定定义低危的证据，描述实施前的要求；（2）风险分层对女性的影响很复杂，重点是获得女性的认可；（3）切实实施低危途径，突出可行性问题。
总体而言，国家医疗保健政策决策者似乎认为，风险分层的乳腺筛查原则上是可以接受的。然而，在国家计划中实施之前，必须解决关键障碍。
