De Nard Francesca, Deandrea Silvia, Bastiampillai Anan Judina, Cavazzana Laura, Carnevali Davide, Principi Niccolò, Luconi Ester, Schulz Peter Johannes, Castaldi Silvana, Silvestri Anna Rita
Scuola di specializzazione in igiene e medicina preventiva, Dipartimento di scienze biomediche per la salute, Università degli Studi di Milano;
UOC medicina preventiva di comunità-screening, Agenzia di tutela della salute di Milano Città Metropolitana, Milano.
Epidemiol Prev. 2021 Jul-Aug;45(4):271-280. doi: 10.19191/EP21.4.P271.083.
communicating breast cancer screening (BCS) limits and overdiagnosis implies providing complete and balanced information to allow informed decision-making.
to describe women's perceptions, preconceptions, and information preferences regarding the breast cancer screening (BCS) programme paper and web information materials of the Agency for Health Protection of the Metropolitan Area of Milan (Lombardy Region, Northern Italy).
qualitative, descriptive study.
participants' voluntary recruitment took place in the registration departments of three hospitals. Participants were purposively recruited based on sociodemographic characteristics of the target population of the programme (44 women aged 40-74 years, living in the Metropolitan Area of Milan). In each material type subgroup, different health literacy levels and age classes were included, until thematic saturation was reached.
thematic analysis of qualitative data collected during think-aloud interviews.
the thematic analysis identified 5 main themes: 1. validation of the information reported in the materials, according to the interviewees' personal experiences;2. information preferences of particular subgroups of women, which led to a tailored approach for the web materials;3. negative emotions elicited while receiving information regarding BCS limits, which guided the rewriting of certain definitions; 4. disproportioned risk perception, with greater weight attributed to the risk of false negative results than the risk of overdiagnosis; 5. organizational preferences regarding the type and frequency of the provided tests and the age limits of the programme.
in the present sample of women living in the Metropolitan Area of Milan, knowledge and comprehension of overdiagnosis are scarce. The main reasons for distrust in the BCS programme rely on the preexisting beliefs regarding the most appropriate tests and age limits. These beliefs were established from previously received information, inconsistent with that officially provided by the programme.
传达乳腺癌筛查（BCS）的局限性和过度诊断意味着提供完整且平衡的信息，以促成明智的决策。
描述女性对米兰都会区（意大利北部伦巴第大区）卫生防护局乳腺癌筛查（BCS）项目纸质及网络信息材料的认知、先入之见和信息偏好。
定性描述性研究。
在三家医院的挂号处进行参与者的自愿招募。根据该项目目标人群的社会人口学特征（44名年龄在40 - 74岁、居住在米兰都会区的女性）进行有目的的招募。在每种材料类型亚组中，纳入不同健康素养水平和年龄组，直至达到主题饱和。
对出声思考访谈期间收集的定性数据进行主题分析。
主题分析确定了5个主要主题：1. 根据受访者的个人经历对材料中报告的信息进行验证；2. 特定女性亚组的信息偏好，这导致了网络材料的定制方法；3. 在接收有关BCS局限性的信息时引发的负面情绪，这指导了某些定义的重新编写；4. 风险感知不均衡，对假阴性结果风险的重视程度高于过度诊断风险；5. 关于所提供检查的类型和频率以及项目年龄限制的组织偏好。
在目前居住在米兰都会区的女性样本中，对过度诊断的了解和理解较少。对BCS项目不信任的主要原因在于对最合适的检查和年龄限制的既有观念。这些观念是基于先前收到的与该项目官方提供的信息不一致的信息而形成的。
