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How do we achieve informed choice for women considering breast screening?

Abstract

OBJECTIVE

In current medical literature, mammography and other cancer screening programs are subject to controversy because of debate about the magnitude and nature of the benefits and harms. This paper discusses the issues around informed choice for women considering breast screening.

METHOD

We discuss qualitative and quantitative studies of women's attitudes to breast screening and informed choice.

RESULTS

Women view breast screening as a way of avoiding potential regret, and reassurance from normal results is highly valued. Screening participants acknowledge anxiety about false positives but awareness regarding potential overdetection of indolent breast cancer is minimal, and research is needed to assess how better understanding of screening downsides may affect women's views. In any case, weighing up screening advantages and disadvantages is sensitive to personal preferences.

CONCLUSIONS

Communicators have an ethical obligation to make balanced information available to women, which is flexible enough to respond to the level of detail and involvement desired by each individual. Many women want to know more and to participate more actively in screening decisions. Techniques have been developed to present balanced information and support individual decision making in ways that are accessible and empowering for the wider community. Evaluations of breast cancer screening must integrate clinical data with evidence on the perspectives of women themselves.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Screening and Test Evaluation Program, Sydney School of Public Health, Edward Ford Bldg (A27), University of Sydney, NSW 2006, Australia. jolyn.hersch@sydney.edu.au

    , , , , ,

    Source

    Preventive medicine 53:3 2011 Sep pg 144-6

    MeSH

    Breast Neoplasms
    Choice Behavior
    Decision Making
    Early Detection of Cancer
    Female
    Health Education
    Health Knowledge, Attitudes, Practice
    Humans
    Informed Consent
    Patient Education as Topic
    Qualitative Research
    Women's Health

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    21723312

    Citation

    TY - JOUR T1 - How do we achieve informed choice for women considering breast screening? AU - Hersch,Jolyn, AU - Jansen,Jesse, AU - Irwig,Les, AU - Barratt,Alexandra, AU - Thornton,Hazel, AU - Howard,Kirsten, AU - McCaffery,Kirsten, Y1 - 2011/06/24/ PY - 2011/04/07/received PY - 2011/06/16/revised PY - 2011/06/17/accepted PY - 2011/7/5/entrez PY - 2011/7/5/pubmed PY - 2012/1/27/medline SP - 144 EP - 6 JF - Preventive medicine JO - Prev Med VL - 53 IS - 3 N2 - OBJECTIVE: In current medical literature, mammography and other cancer screening programs are subject to controversy because of debate about the magnitude and nature of the benefits and harms. This paper discusses the issues around informed choice for women considering breast screening. METHOD: We discuss qualitative and quantitative studies of women's attitudes to breast screening and informed choice. RESULTS: Women view breast screening as a way of avoiding potential regret, and reassurance from normal results is highly valued. Screening participants acknowledge anxiety about false positives but awareness regarding potential overdetection of indolent breast cancer is minimal, and research is needed to assess how better understanding of screening downsides may affect women's views. In any case, weighing up screening advantages and disadvantages is sensitive to personal preferences. CONCLUSIONS: Communicators have an ethical obligation to make balanced information available to women, which is flexible enough to respond to the level of detail and involvement desired by each individual. Many women want to know more and to participate more actively in screening decisions. Techniques have been developed to present balanced information and support individual decision making in ways that are accessible and empowering for the wider community. Evaluations of breast cancer screening must integrate clinical data with evidence on the perspectives of women themselves. SN - 1096-0260 UR - https://www.unboundmedicine.com/medline/citation/21723312/How_do_we_achieve_informed_choice_for_women_considering_breast_screening L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-7435(11)00239-8 ER -