Risk stratified breast cancer screening: UK healthcare policy decision-making stakeholders' views on a low-risk breast screening pathway.
Breast cancer
Implementation
Risk assessment
Risk stratification
Screening
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
22 Jul 2020
22 Jul 2020
Historique:
received:
07
05
2020
accepted:
09
07
2020
entrez:
24
7
2020
pubmed:
24
7
2020
medline:
7
2
2021
Statut:
epublish
Résumé
There is international interest in risk-stratification of breast screening programmes to allow women at higher risk to benefit from more frequent screening and chemoprevention. Risk-stratification also identifies women at low-risk who could be screened less frequently, as the harms of breast screening may outweigh benefits for this group. The present research aimed to elicit the views of national healthcare policy decision-makers regarding implementation of less frequent screening intervals for women at low-risk. Seventeen professionals were purposively recruited to ensure relevant professional group representation directly or indirectly associated with the UK National Screening Committee and National Institute for Health and Care Excellence (NICE) clinical guidelines. Interviews were analysed using thematic analysis. Three themes are reported: (1) producing the evidence defining low-risk, describing requirements preceding implementation; (2) the impact of risk stratification on women is complicated, focusing on gaining acceptability from women; and (3) practically implementing a low-risk pathway, where feasibility questions are highlighted. Overall, national healthcare policy decision-makers appear to believe that risk-stratified breast screening is acceptable, in principle. It will however be essential to address key obstacles prior to implementation in national programmes.
Sections du résumé
BACKGROUND
BACKGROUND
There is international interest in risk-stratification of breast screening programmes to allow women at higher risk to benefit from more frequent screening and chemoprevention. Risk-stratification also identifies women at low-risk who could be screened less frequently, as the harms of breast screening may outweigh benefits for this group. The present research aimed to elicit the views of national healthcare policy decision-makers regarding implementation of less frequent screening intervals for women at low-risk.
METHODS
METHODS
Seventeen professionals were purposively recruited to ensure relevant professional group representation directly or indirectly associated with the UK National Screening Committee and National Institute for Health and Care Excellence (NICE) clinical guidelines. Interviews were analysed using thematic analysis.
RESULTS
RESULTS
Three themes are reported: (1) producing the evidence defining low-risk, describing requirements preceding implementation; (2) the impact of risk stratification on women is complicated, focusing on gaining acceptability from women; and (3) practically implementing a low-risk pathway, where feasibility questions are highlighted.
CONCLUSIONS
CONCLUSIONS
Overall, national healthcare policy decision-makers appear to believe that risk-stratified breast screening is acceptable, in principle. It will however be essential to address key obstacles prior to implementation in national programmes.
Identifiants
pubmed: 32698780
doi: 10.1186/s12885-020-07158-9
pii: 10.1186/s12885-020-07158-9
pmc: PMC7374862
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
680Subventions
Organisme : Department of Health
ID : RP-PG-1214-20016
Pays : United Kingdom
Organisme : Manchester Biomedical Research Centre
ID : IS-BRC-1215-200007
Organisme : Breast Cancer Now
ID : 2018RP005
Pays : United Kingdom
Organisme : Programme Grants for Applied Research
ID : RP-PG-1214-20016
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