Most women have positive attitudes toward learning their breast cancer risk category and screening plan, according to research published December 29 in Clinical Breast Cancer.
A team led by Jennifer Brooks, PhD, from the University of Toronto in Ontario, Canada, reported that over seven in 10 women perceive easing worry as an advantage of learning their risk. However, women from higher-risk and marginalized groups reported more concerns than women at average risk.
“Findings highlight the need for clear communication and tailored support to ensure effective implementation of risk-stratified screening,” the Brooks team wrote.
Many breast cancer screening programs with mammography are age-based. However, risk-stratified screening has emerged as an alternative approach. Proponents of the latter say this method includes multiple risk factors, including age, family history, mammographic density, and lifestyle factors.
Risk-stratified screening recommends earlier and more frequent screening for women at higher risk of breast cancer while also aiming to reduce unnecessary interventions for women at lower risk.
Brooks and colleagues analyzed prospective data from the Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation (PERSPECTIVE I&I) project. This trial aimed to improve personalized risk assessment and examine key factors for the successful implementation of risk-stratified screening in Canada.
For their analysis, the researchers focused on perceived advantages and disadvantages of receiving personalized breast cancer risk information and a corresponding screening plan.
The study included 3,319 women aged 40 to 69 years from the Canadian provinces of Ontario and Quebec. These women underwent multifactorial risk assessments, with 78.9% at average risk, 16.4% at higher-than-average risk, and 4.6% at high risk. The women also completed questionnaires on attitudes toward learning their risk before, at the time of, and one year after risk communication.
The team reported the following findings:
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At the time of risk communication, 72.9% of women perceived “easing worry” as an advantage of learning their risk.
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Women at higher risk were more likely to report that risk communication did not ease their worry.
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Minority participants were more likely to view “complicated information” as a disadvantage, with an odds ratio (OR) of 1.86.
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Women with lower educational attainment were also more likely to view “complicated information” as a disadvantage. Women with a high school-level education or lower had an OR of 1.77 compared with women with college-, apprenticeship-, or trade-level education (OR, 1.54).
Finally, the researchers found that women from Ontario were more likely to view risk communication as “information I do not want to know” (OR, 0.44) compared with participants from Quebec.
The study authors highlighted that “clear communication, healthcare provider support, and adaptation to regional resources” are needed for successful implementation of risk-stratified screening.
Read the full study here.