McWilliams Lorna, Roux Alexandra, Hawkes Rhiannon, Cholerton Rachel, Delattre Hélène, Bernoux Agnès, Forzy Marie-Laure, Evans D Gareth, Balleyguier Corinne, Keatley Debbie, Vissac-Sabatier Cécile, Delaloge Suzette, de Montgolfier Sandrine, French David P
Manchester Centre for Health Psychology, University of Manchester, Manchester, UK.
Inserm, IRD, SESSTIM, ISSPAM, Aix Marseille Univ, Marseille, France.
Psychol Health. 2024 Sep 2:1-23. doi: 10.1080/08870446.2024.2395856.
Risk-stratification should improve the benefits-to-harms ratio for breast screening, whereby higher-risk women receive additional screening and low-risk women are screened less. This study investigated the effects of healthcare context by comparing how women in England and France experienced risk-based breast screening.
Fifty-two women were purposively sampled from participants who underwent risk-based screening in the MyPeBS trial. Women received objectively-derived 5-year breast cancer risk estimates (low = < 1%, average = 1-1.66%, high = ≥ 1.67 to <6%, very-high-risk = ≥ 6%). This determined future trial-related screening schedules and prevention options. Semi-structured interviews were transcribed for thematic framework analysis.
Two overarching themes were produced: and . Overall, risk-based breast screening was viewed positively. However, trial procedures, especially in risk estimate provision, differed across sites. Women at increased risk were more reassured when appointments were with specialist healthcare professionals (HCP). When absent, this resulted in reduced satisfaction with risk communication and greater uncertainty about its personal relevance. Low-risk women's views on extended mammogram schedules seemed linked to how health services are organised differently.
Context is an important consideration regarding acceptability of healthcare innovations such as risk-stratified screening: it should not be assumed that findings from one country apply universally.
风险分层应提高乳腺癌筛查的利弊比，即高风险女性接受额外筛查，低风险女性接受较少筛查。本研究通过比较英国和法国女性接受基于风险的乳腺癌筛查的体验，调查了医疗环境的影响。
从参与MyPeBS试验并接受基于风险筛查的参与者中，有目的地抽取了52名女性。女性接受客观得出的5年乳腺癌风险估计（低风险=＜1%，平均风险=1-1.66%，高风险=≥1.67%至＜6%，极高风险=≥6%）。这决定了未来与试验相关的筛查计划和预防方案。对半结构化访谈进行转录，以进行主题框架分析。
产生了两个总体主题：[此处原文缺失具体主题内容]。总体而言，基于风险的乳腺癌筛查受到积极评价。然而，试验程序，尤其是在风险估计提供方面，各地点有所不同。当与专科医疗保健专业人员（HCP）预约时，风险增加的女性会更安心。若没有这种情况，这会导致对风险沟通的满意度降低，以及对其个人相关性的更大不确定性。低风险女性对延长乳房X光检查计划的看法似乎与医疗服务的不同组织方式有关。
对于风险分层筛查等医疗创新的可接受性，环境是一个重要考虑因素：不应假定一个国家的研究结果具有普遍适用性。
