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. 2020 Mar 24;20(1):247.
doi: 10.1186/s12885-020-06745-0.

European women's perceptions of the implementation and organisation of risk-based breast cancer screening and prevention: a qualitative study

Linda Rainey  1 , Daniëlle van der Waal  2 , Anna Jervaeus  3 , Louise S Donnelly  4 , D Gareth Evans  4   5   6 , Mattias Hammarström  7 , Per Hall  7   8 , Yvonne Wengström  3   9 , Mireille J M Broeders  2   10
Affiliations

European women's perceptions of the implementation and organisation of risk-based breast cancer screening and prevention: a qualitative study

Linda Rainey et al. BMC Cancer. .

Abstract

Background: Increased knowledge of breast cancer risk factors has meant that we are currently exploring risk-based screening, i.e. determining screening strategies based on women's varying levels of risk. This also enables risk management through primary prevention strategies, e.g. a lifestyle programme or risk-reducing medication. However, future implementation of risk-based screening and prevention will warrant significant changes in current practice and policy. The present study explores women's perceptions of the implementation and organisation of risk-based breast cancer screening and prevention to optimise acceptability and uptake.

Methods: A total of 143 women eligible for breast cancer screening in the Netherlands, the United Kingdom, and Sweden participated in focus group discussions. The focus group discussions were transcribed verbatim and the qualitative data was analysed using thematic analysis.

Results: Women from all three countries generally agreed on the overall proceedings, e.g. a risk assessment after which the risk estimate is communicated via letter (for below average and average risk) or consultation (for moderate and high risk). However, discrepancies in information needs, preferred risk communication format and risk counselling professional were identified between countries. Additionally, a need to educate healthcare professionals on all aspects of the risk-based screening and prevention programme was established.

Conclusion: Women's insights identified the need for country-specific standardised protocols regarding the assessment and communication of risk, and the provision of heterogeneous screening and prevention recommendations, monitoring the principle of solidarity in healthcare policy.

Keywords: Breast cancer; Implementation; Primary prevention; Risk stratification; Screening.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Integration of stages associated with risk-based screening and prevention in a current screening programme
Fig. 2
Fig. 2
Overview of the PROCAS study procedure
See this image and copyright information in PMC

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