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Use of breast screening appointments to provide risk estimates and discuss preventive options

Centre for Cancer Prevention

Project Investigator:  Professor Jack Cuzick

Overview

Whilst the NHSBSP is an excellent early detection service, it does not currently provide women with any information about their personal breast cancer risk or inform them of the kinds of lifestyle factors which can affect this. We think there is a real opportunity for the NHS Breast Cancer Screening Programme to provide both kinds of information. Therefore, we are aiming to set up a pilot study to determine if participants in the screening programme wish to know their risk of developing breast cancer, as predicted by the Cuzick/Tyrer risk assessment model.

A secondary objective is to assess the impact of the risk assessment (RA) on knowledge and associated behaviours, one year after the assessment.

The central hypothesis of the breast cancer risk study is that awareness of personal breast cancer risk will better predispose women to adopt lifestyle behaviours that can reduce exposure to post menopausal breast cancer, other chronic diseases and improve their health and well being in mid life and older age.

Risk communication is a complex area, and in response to fundamental & logistical concerns expressed by staff at the screening units & feedback from the Research for Patient Benefit (RfPB) funding scheme it was decided to introduce an interim piece of survey research which will inform the design of the breast cancer risk study.

From the survey, we hope to ascertain:

  • Women's interest in, receptiveness to and, preferences for receiving a personal appraisal of personal breast cancer risk and how best to present this to motivate adaptive action
  • The perceived benefits, risks, psychological and behavioural effects women anticipate if having this, especially in relation to lifestyle and screening behaviours.
  • Socio demographic and/or ethnic patterning in responses, preferences and anticipated impact on attitudes and behaviour

And more specifically that women :

  • Understand what a personal risk assessment can and cannot tell them about their future risk of developing - or not developing - breast cancer
  • Are aware that certain factors can increase or reduce post menopausal breast cancer risk BUT that these do not guarantee outcome
  • Understand the type and level of lifestyle improvements needed, why and how much this may affect their risk
  • Receive lifestyle information in a style, format and via a medium that they find easy to understand, motivates and helps them to implement improvements
  • Anticipate more benefits than disadvantages in receiving a personal risk assessment, especially if higher than average
  • Do not feel this would increase anxiety about breast cancer or discourage future attendance at NHS mammography

 

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