女性与年龄相关的乳房 X 光筛查中断的体验：一项定性访谈研究。
Women's experiences of age-related discontinuation from mammography screening: A qualitative interview study.
机构信息
Center for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Primary Health Care Research Unit, Region Zealand, Denmark.
出版信息
Health Expect. 2023 Jun;26(3):1096-1106. doi: 10.1111/hex.13723. Epub 2023 Feb 17.
INTRODUCTION
In Denmark, women are discontinued from mammography screening at age 69 due to decreased likelihood of benefits and increased likelihood of harm. The risk of harm increases with age and includes false positives, overdiagnosis and overtreatment. In a questionnaire survey, 24 women expressed unsolicited concerns about being discontinued from mammography screening due to age. This calls for further investigation of experiences related to discontinuation from screening.
METHODS
We invited the women, who had left comments on the questionnaire, to participate in in-depth interviews with the purpose to explore their reactions, preferences, and conceptions about mammography screening and discontinuation. The interviews lasted 1-4 h and were followed up with a telephone interview 2 weeks after the initial interview.
RESULTS
The women had high expectations of the benefits of mammography screening and felt that participation was a moral obligation. Following that, they perceived the screening discontinuation as a result of societal age discrimination and consequently felt devalued. Further, the women perceived the discontinuation as a health threat, felt more susceptible to late diagnosis and death, and therefore sought out new ways to control their risk of breast cancer.
CONCLUSION
Our findings indicate that the age-related discontinuation from mammography screening might be of more importance than previously assumed. This study raises important questions about screening ethics, and we encourage research to explore this in other settings.
PATIENT AND PUBLIC CONTRIBUTION
This study was conducted as a result of the women's unsolicited concerns about being discontinued from screening. This particular group contributed to the study with their own statements, interpretations and perspectives on the discontinuation of screening, and the initial analysis of data was discussed with the women during follow-up interviews.
简介
在丹麦，由于获益可能性降低和危害可能性增加，女性在 69 岁时被停止进行乳房 X 光筛查。危害风险随年龄增加而增加，包括假阳性、过度诊断和过度治疗。在问卷调查中，24 名女性对因年龄而被停止乳房 X 光筛查表示出未经请求的担忧。这需要进一步调查与筛查中断相关的经验。
方法
我们邀请了对问卷发表评论的女性参与深入访谈，目的是探索她们对乳房 X 光筛查和停止筛查的反应、偏好和概念。访谈持续 1-4 小时，并在初次访谈后 2 周进行电话随访。
结果
这些女性对乳房 X 光筛查的益处抱有很高的期望，并认为参与是一种道德义务。之后，她们将筛查停止视为社会年龄歧视的结果，因此感到被贬低。此外，女性将其视为健康威胁，感到更容易被漏诊和死亡，因此寻求新的方法来控制患乳腺癌的风险。
结论
我们的研究结果表明，与年龄相关的乳房 X 光筛查停止可能比之前认为的更为重要。本研究提出了关于筛查伦理的重要问题，我们鼓励研究在其他环境中探索这一问题。
患者和公众参与
本研究是由于女性对被停止筛查的未经请求的担忧而进行的。该特定群体通过自己的陈述、对筛查中断的解释和观点，以及对数据的初步分析，对研究做出了贡献，并在随访访谈中与女性讨论了这些贡献。
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