Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J Gen Intern Med. 2022 Apr;37(5):1145-1154. doi: 10.1007/s11606-021-07336-w. Epub 2022 Jan 11.
Conflicting breast cancer screening recommendations have the potential to diminish informed decision making about screening.
We examined the knowledge, attitudes, and intentions related to divergent recommendations for breast cancer screening among racially/ethnically diverse women.
We used a multimethod study design employing focus groups and questionnaires. Focus groups included: (1) two 10-min presentations on the national screening recommendations and the potential benefits and harms of screening and (2) an interactive discussion. Data were collected: 8/3/2017 to 11/19/2019. Analysis occurred from 1/21/2019 to 7/24/2020.
Participants were (1) women 40-75 years; (2) English or Spanish speaking; (3)self-identified as Latina, Black, or non-Latina White; and (4) no known increased risk for breast cancer.
Main outcomes were participants' knowledge and perceptions of benefits and harms of screening mammography and their screening intentions. Focus groups were transcribed and analyzed using a qualitative descriptive approach. Quantitative data were summarized using descriptive statistics.
One hundred thirty-four women (n=52, 40-49 years; n=82, 50-75 years) participated in 28 focus groups. Participants were Latina (n=44); Black (n=51); and non-Latina White (n=39). Approximately one-quarter (n=32) had limited health literacy and almost one-fifth (n=23) had limited numeracy. In the context of differing national screening recommendations, participants questioned the motives of the recommendation-making agencies, including the role of costs and how costs were considered when making screening recommendations. Participants expressed concern that they were not represented (e.g., race/ethnicity) in the data informing the recommendations. Immediately following the focus groups, most participants expressed intention to screen within the upcoming year (pre n=100 vs. post n=107).
Divergent breast cancer screening recommendations may lead to mistrust and paradoxically reinforce high overall enthusiasm for screening.
相互冲突的乳腺癌筛查建议可能会降低人们对筛查的知情决策能力。
我们研究了不同种族/族裔背景的女性对乳腺癌筛查的推荐建议存在差异时，她们的相关知识、态度和意向。
我们采用了一种多方法研究设计，使用焦点小组和问卷。焦点小组包括：（1）关于国家筛查建议以及筛查的潜在益处和危害的两个 10 分钟演示，（2）互动讨论。数据收集时间：2017 年 8 月 3 日至 2019 年 11 月 19 日。分析时间：2019 年 1 月 21 日至 2020 年 7 月 24 日。
参与者为（1）40-75 岁的女性；（2）英语或西班牙语；（3）自认为是拉丁裔、黑人或非拉丁裔白人；（4）无已知乳腺癌风险增加。
主要结果是参与者对筛查乳房 X 光检查的益处和危害的了解和看法，以及他们的筛查意向。焦点小组的转录内容使用定性描述方法进行分析。定量数据使用描述性统计进行总结。
134 名女性（n=52，40-49 岁；n=82，50-75 岁）参加了 28 个焦点小组。参与者是拉丁裔（n=44）；黑人（n=51）；非拉丁裔白人（n=39）。大约四分之一（n=32）的参与者文化程度有限，近五分之一（n=23）的参与者计算能力有限。在不同的国家筛查建议的背景下，参与者质疑了建议制定机构的动机，包括成本的作用以及在制定筛查建议时如何考虑成本。参与者担心他们在提供建议的数据中没有得到代表（例如，种族/族裔）。在焦点小组结束后不久，大多数参与者表示在未来一年内有筛查意向（之前 n=100 与之后 n=107）。
相互冲突的乳腺癌筛查建议可能导致不信任，并荒谬地强化人们对筛查的总体热情。
