Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Oxford Road, M13 9PL, Manchester, UK.
NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, England.
Br J Cancer. 2023 Aug;129(2):356-365. doi: 10.1038/s41416-023-02268-0. Epub 2023 May 24.
Risk-stratified screening is being considered for national breast screening programmes. It is unclear how women experience risk-stratified screening and receipt of breast cancer risk information in real time. This study aimed to explore the psychological impact of undergoing risk-stratified screening within England's NHS Breast Screening Programme.
Individual telephone interviews were conducted with 40 women who participated in the BC-Predict study and received a letter indicating their estimated breast cancer risk as one of four risk categories: low (<2% 10-year risk), average (2-4.99%), above average (moderate; 5-7.99%) or high (≥8%). Audio-recorded interview transcriptions were analysed using reflexive thematic analysis.
Two themes were produced: 'From risk expectations to what's my future health story?' highlights that women overall valued the opportunity to receive risk estimates; however, when these were discordant with perceived risk, this causes temporary distress or rejection of the information. 'Being a good (woman) citizen' where women felt positive contributing to society but may feel judged if they then cannot exert agency over the management of their risk or access follow-up support CONCLUSIONS: Risk-stratified breast screening was generally accepted without causing long-lasting distress; however, issues related to risk communication and access to care pathways need to be considered for implementation.
风险分层筛查正被考虑用于国家乳腺癌筛查计划。目前尚不清楚女性在实时体验风险分层筛查和获得乳腺癌风险信息时的感受。本研究旨在探讨英格兰国民保健署（NHS）乳腺癌筛查计划中进行风险分层筛查对女性心理的影响。
对参与 BC-Predict 研究并收到一封信，告知其乳腺癌风险估计值为四个风险类别之一的 40 名女性进行了个人电话访谈：低（<2%的 10 年风险）、平均（2-4.99%）、中偏高（中度；5-7.99%）或高（≥8%）。使用反思性主题分析对录音采访转录本进行了分析。
产生了两个主题：“从风险预期到我的未来健康故事是什么？”突出了女性总体上重视获得风险估计值的机会；然而，当这些估计值与感知风险不一致时，会导致暂时的痛苦或对信息的拒绝。“做一个好（女）公民”，女性觉得自己为社会做贡献是积极的，但如果她们无法对自己的风险进行管理或获得后续支持，她们可能会感到被评判。
风险分层乳腺癌筛查通常被接受，不会造成持久的痛苦；然而，需要考虑风险沟通和获得护理途径的问题，以便实施。
