Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.
Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Health Expect. 2021 Aug;24(4):1326-1336. doi: 10.1111/hex.13267. Epub 2021 May 11.
There is mounting evidence of the benefit of risk-stratified (risk-tailored) cancer population screening, when compared to standard approaches. However, shifting towards this approach involves changes to practice that may give rise to implementation challenges.
To explore the public's potential acceptance of risk-stratified screening across different cancer types, including reducing screening frequency if at low risk and the use of personal risk information, to inform implementation strategies.
Semi-structured interviews were conducted with 40 public participants; half had received personal genomic risk information and half had not. Participants were prompted to consider different cancers. Data were analysed thematically as one dataset.
Themes included the following: (a) a sense of security; (b) tailored screening is common sense; (c) risk and the need to take action; (d) not every cancer is the same; and (e) trust and belief in health messages. Both groups expressed similar views. Participants were broadly supportive of risk-stratified screening across different cancer types, with strong support for increased screening frequency for high-risk groups. They were less supportive of reduced screening frequency or no screening for low-risk groups. Findings suggest the public will be amenable to reducing screening when the test is invasive and uncomfortable; be less opposed to forgo screening if offered the opportunity to screen at some stage; and view visible cancers such as melanoma differently.
Approaching distinct cancer types differently, tailoring messages for different audiences and understanding reasons for participating in screening may assist with designing future implementation strategies for risk-stratified cancer screening.
与标准方法相比，风险分层（风险定制）癌症人群筛查的益处证据越来越多。然而，向这种方法转变涉及到实践的改变，可能会带来实施挑战。
探索公众对不同癌症类型的风险分层筛查的潜在接受程度，包括降低低危人群的筛查频率以及使用个人风险信息，为实施策略提供信息。
对 40 名公众参与者进行了半结构化访谈；一半参与者接受了个人基因组风险信息，另一半则没有。参与者被提示考虑不同的癌症。数据作为一个数据集进行主题分析。
主题包括：（a）安全感；（b）量身定制的筛查是常识；（c）风险和采取行动的必要性；（d）并非所有癌症都相同；以及（e）对健康信息的信任和信念。两个组都表达了类似的观点。参与者普遍支持不同癌症类型的风险分层筛查，强烈支持高危人群增加筛查频率。他们对低危人群减少筛查频率或不筛查的支持程度较低。研究结果表明，公众对不同侵入性和不舒适的筛查测试可能会接受降低筛查频率；如果有机会在某个阶段进行筛查，他们可能不太反对放弃筛查；并且会对黑色素瘤等可见癌症有不同的看法。
针对不同的癌症类型采取不同的方法，为不同的受众定制信息，并了解参与筛查的原因，可能有助于设计未来风险分层癌症筛查的实施策略。
