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Randomized Controlled Trial
. 2016 Mar 15;7(11):12885-92.
doi: 10.18632/oncotarget.7332.

Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group

Aurelie Bourmaud  1   2 , Patricia Soler-Michel  3 , Mathieu Oriol  1   4 , Véronique Regnier  1 , Fabien Tinquaut  1 , Alice Nourissat  1 , Alain Bremond  4 , Nora Moumjid  5   6   7 , Franck Chauvin  1   2   4
Affiliations
Randomized Controlled Trial

Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group

Aurelie Bourmaud et al. Oncotarget. .

Abstract

Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p < 0.0001) and medium household income (RR = 1.05; [95%IC: 1.01-1.09]; p = 0.0074) were independently associated with attendance for screening. This large-scale study demonstrates that the decision aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated.

Keywords: breast cancer screening; decision aid; decision making patient education; informed decision; randomized control trial.

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Conflict of interest statement

CONFLICTS OF INTEREST

PSM declares a conflict of interest through her activity, being a practionner involved in breast cancer screening promotion at a local level. All the others authors declare no financial support for the submitted work; no relationships that might have an interest in the submitted work in the previous three years; None of their spouses, partners, or children have financial relationships that may be relevant to the submitted work; and none have non-financial interests that may be relevant to the submitted work.

Figures

Figure 1
Figure 1. Randomization and follow-up of study participants
Some women were excluded because there was a delay between the invitation being sent by the cancer screening association and its reception by the women; during the delay some of the randomized women had already attended breast cancer screening since they did not need to take the invitation letter with them.
Figure 2
Figure 2. Sub-group analyses to identify baseline characteristics associated with breast cancer screening attendance
Results are reported as odds ratios with 95% confidence intervals (CI) (horizontal bar). The dotted vertical line represents the odds ratio in the whole sample (odds ratio 0.86, 95% CI: 0.79-0.94, P = 0.0008).
See this image and copyright information in PMC

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