Skip to main content
Top
Published in: BMC Cancer 1/2024

Open Access 01-12-2024 | Breast Cancer | Research

Attitudes towards risk-stratified breast cancer screening: a population-based survey among 5,001 Danish women

Authors: Louise Hougaard Loft, Line Hjøllund Pedersen, Janne Bigaard, Stig Egil Bojesen

Published in: BMC Cancer | Issue 1/2024

Login to get access

Abstract

Background

The individual woman’s risk of being diagnosed with breast cancer can now be estimated more precisely, and screening can be stratified accordingly. The risk assessment requires that women are willing to provide a blood test, additional personal information, to know their risk, and alter screening intervals. This study aimed to investigate Danish women’s attitudes towards risk-stratified breast cancer screening.

Methods

An online, cross-sectional survey was conducted among Danish women aged 52–67 years. We used logistic regression analyses to assess how personal characteristics were associated with the women’s attitudes.

Results

5,001 women completed the survey (response rate 44%) of which 74% approved of risk estimation to potentially alter their screening intervals. However, only 42% would accept an extended screening interval if found to have low breast cancer risk, while 89% would accept a reduced interval if at high risk. The main determinants of these attitudes were age, education, screening participation, history of breast cancer, perceived breast cancer risk and to some extent breast cancer worry.

Conclusion

This study indicates that women are positive towards risk-stratified breast cancer screening. However, reservations and knowledge among subgroups of women must be carefully considered and addressed before wider implementation of risk-stratified breast cancer screening in a national program.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin. 2018;68(6):394–424.CrossRef Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin. 2018;68(6):394–424.CrossRef
2.
go back to reference Coleman MP, Forman D, Bryant H, Butler J, Rachet B, Maringe C, et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet. 2011;377(9760):127–38.CrossRefPubMedPubMedCentral Coleman MP, Forman D, Bryant H, Butler J, Rachet B, Maringe C, et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet. 2011;377(9760):127–38.CrossRefPubMedPubMedCentral
3.
go back to reference Regionernes Kliniske Kvalitetsudviklingsprogram. Dansk Kvalitetsdatabase for Mammografiscreening. Årsrapport 2021. 2022. Regionernes Kliniske Kvalitetsudviklingsprogram. Dansk Kvalitetsdatabase for Mammografiscreening. Årsrapport 2021. 2022.
4.
go back to reference Yang X, Eriksson M, Czene K, Lee A, Leslie G, Lush M et al. Prospective validation of the BOADICEA multifactorial breast cancer risk prediction model in a large prospective cohort study. J Med Genet. 2022. Yang X, Eriksson M, Czene K, Lee A, Leslie G, Lush M et al. Prospective validation of the BOADICEA multifactorial breast cancer risk prediction model in a large prospective cohort study. J Med Genet. 2022.
5.
go back to reference Vilaprinyo E, Forné C, Carles M, Sala M, Pla R, Castells X, et al. Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer. PLoS ONE. 2014;9(2):e86858.CrossRefPubMedPubMedCentral Vilaprinyo E, Forné C, Carles M, Sala M, Pla R, Castells X, et al. Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer. PLoS ONE. 2014;9(2):e86858.CrossRefPubMedPubMedCentral
6.
go back to reference Roux A, Cholerton R, Sicsic J, Moumjid N, French DP, Giorgi Rossi P, et al. Study protocol comparing the ethical, psychological and socio-economic impact of personalised breast cancer screening to that of standard screening in the my personal breast screening (MyPeBS) randomised clinical trial. BMC Cancer. 2022;22(1):507.CrossRefPubMedPubMedCentral Roux A, Cholerton R, Sicsic J, Moumjid N, French DP, Giorgi Rossi P, et al. Study protocol comparing the ethical, psychological and socio-economic impact of personalised breast cancer screening to that of standard screening in the my personal breast screening (MyPeBS) randomised clinical trial. BMC Cancer. 2022;22(1):507.CrossRefPubMedPubMedCentral
7.
go back to reference French DP, Astley S, Brentnall AR, Cuzick J, Dobrashian R, Duffy SW, et al. What are the benefits and harms of risk stratified screening as part of the NHS breast screening Programme? Study protocol for a multi-site non-randomised comparison of BC-predict versus usual screening (NCT04359420). BMC Cancer. 2020;20(1):570.CrossRefPubMedPubMedCentral French DP, Astley S, Brentnall AR, Cuzick J, Dobrashian R, Duffy SW, et al. What are the benefits and harms of risk stratified screening as part of the NHS breast screening Programme? Study protocol for a multi-site non-randomised comparison of BC-predict versus usual screening (NCT04359420). BMC Cancer. 2020;20(1):570.CrossRefPubMedPubMedCentral
8.
go back to reference Esserman L, Eklund M, Veer Lvt, Shieh Y, Tice J, Ziv E, et al. The WISDOM study: a new approach to screening can and should be tested. Breast Cancer Res Treat. 2021;189(3):593–8.CrossRefPubMed Esserman L, Eklund M, Veer Lvt, Shieh Y, Tice J, Ziv E, et al. The WISDOM study: a new approach to screening can and should be tested. Breast Cancer Res Treat. 2021;189(3):593–8.CrossRefPubMed
9.
go back to reference Brooks JD, Nabi HH, Andrulis IL, Antoniou AC, Chiquette J, Després P et al. Personalized Risk Assessment for Prevention and early detection of breast Cancer: integration and implementation (PERSPECTIVE I&I). J Pers Med. 2021;11(6). Brooks JD, Nabi HH, Andrulis IL, Antoniou AC, Chiquette J, Després P et al. Personalized Risk Assessment for Prevention and early detection of breast Cancer: integration and implementation (PERSPECTIVE I&I). J Pers Med. 2021;11(6).
10.
go back to reference Committee on Health Research Ethics. Number: H-23017474. Capital Region, Denmark2023. Committee on Health Research Ethics. Number: H-23017474. Capital Region, Denmark2023.
11.
go back to reference Lee A, Mavaddat N, Wilcox AN, Cunningham AP, Carver T, Hartley S, et al. BOADICEA: a comprehensive breast cancer risk prediction model incorporating genetic and nongenetic risk factors. Genet Med. 2019;21(8):1708–18.CrossRefPubMedPubMedCentral Lee A, Mavaddat N, Wilcox AN, Cunningham AP, Carver T, Hartley S, et al. BOADICEA: a comprehensive breast cancer risk prediction model incorporating genetic and nongenetic risk factors. Genet Med. 2019;21(8):1708–18.CrossRefPubMedPubMedCentral
12.
go back to reference Rainey L, van der Waal D, Broeders MJM. Dutch women’s intended participation in a risk-based breast cancer screening and prevention programme: a survey study identifying preferences, facilitators and barriers. BMC Cancer. 2020;20(1):965.CrossRefPubMedPubMedCentral Rainey L, van der Waal D, Broeders MJM. Dutch women’s intended participation in a risk-based breast cancer screening and prevention programme: a survey study identifying preferences, facilitators and barriers. BMC Cancer. 2020;20(1):965.CrossRefPubMedPubMedCentral
13.
go back to reference Fisher BA, Wilkinson L, Valencia A. Women’s interest in a personal breast cancer risk assessment and lifestyle advice at NHS mammography screening. J Public Health. 2017;39(1):113–21. Fisher BA, Wilkinson L, Valencia A. Women’s interest in a personal breast cancer risk assessment and lifestyle advice at NHS mammography screening. J Public Health. 2017;39(1):113–21.
14.
go back to reference Ghanouni A, Sanderson SC, Pashayan N, Renzi C, von Wagner C, Waller J. Attitudes towards risk-stratified breast cancer screening among women in England: a cross-sectional survey. J Med Screen. 2020;27(3):138–45.CrossRefPubMed Ghanouni A, Sanderson SC, Pashayan N, Renzi C, von Wagner C, Waller J. Attitudes towards risk-stratified breast cancer screening among women in England: a cross-sectional survey. J Med Screen. 2020;27(3):138–45.CrossRefPubMed
15.
go back to reference Koitsalu M, Sprangers MA, Eklund M, Czene K, Hall P, Grönberg H, et al. Public interest in and acceptability of the prospect of risk-stratified screening for breast and prostate cancer. Acta Oncol (Stockholm Sweden). 2016;55(1):45–51.CrossRef Koitsalu M, Sprangers MA, Eklund M, Czene K, Hall P, Grönberg H, et al. Public interest in and acceptability of the prospect of risk-stratified screening for breast and prostate cancer. Acta Oncol (Stockholm Sweden). 2016;55(1):45–51.CrossRef
16.
go back to reference Mbuya Bienge C, Pashayan N, Brooks JD, Dorval M, Chiquette J, Eloy L et al. Women’s Views on Multifactorial Breast Cancer Risk Assessment and Risk-Stratified Screening: A Population-Based Survey from Four Provinces in Canada. J Pers Med. 2021;11(2). Mbuya Bienge C, Pashayan N, Brooks JD, Dorval M, Chiquette J, Eloy L et al. Women’s Views on Multifactorial Breast Cancer Risk Assessment and Risk-Stratified Screening: A Population-Based Survey from Four Provinces in Canada. J Pers Med. 2021;11(2).
17.
go back to reference Meisel SF, Pashayan N, Rahman B, Side L, Fraser L, Gessler S, et al. Adjusting the frequency of mammography screening on the basis of genetic risk: attitudes among women in the UK. Breast. 2015;24(3):237–41.CrossRefPubMed Meisel SF, Pashayan N, Rahman B, Side L, Fraser L, Gessler S, et al. Adjusting the frequency of mammography screening on the basis of genetic risk: attitudes among women in the UK. Breast. 2015;24(3):237–41.CrossRefPubMed
18.
go back to reference Kvernrød A-B, Rasmussen CH, Bigaard J, Bojesen SE, Pedersen LH. Attitudes towards risk stratified breast cancer screening in Denmark - a qualitative study. Manuscript in preparation. Kvernrød A-B, Rasmussen CH, Bigaard J, Bojesen SE, Pedersen LH. Attitudes towards risk stratified breast cancer screening in Denmark - a qualitative study. Manuscript in preparation.
19.
go back to reference Evans DG, Donnelly LS, Harkness EF, Astley SM, Stavrinos P, Dawe S, et al. Breast cancer risk feedback to women in the UK NHS breast screening population. Br J Cancer. 2016;114(9):1045–52.CrossRefPubMedPubMedCentral Evans DG, Donnelly LS, Harkness EF, Astley SM, Stavrinos P, Dawe S, et al. Breast cancer risk feedback to women in the UK NHS breast screening population. Br J Cancer. 2016;114(9):1045–52.CrossRefPubMedPubMedCentral
20.
go back to reference Norstat Danmark. norstat. Accessed 2023, June 19. Available from: norstat.dk. (2023). Norstat Danmark. norstat. Accessed 2023, June 19. Available from: norstat.dk. (2023).
21.
go back to reference R Core Team. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2022. R Core Team. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2022.
23.
go back to reference Cameron LD, Diefenbach MA. Responses to information about Psychosocial consequences of genetic testing for breast Cancer susceptibility: influences of Cancer worry and risk perceptions. J Health Psychol. 2001;6(1):47–59.CrossRefPubMed Cameron LD, Diefenbach MA. Responses to information about Psychosocial consequences of genetic testing for breast Cancer susceptibility: influences of Cancer worry and risk perceptions. J Health Psychol. 2001;6(1):47–59.CrossRefPubMed
24.
go back to reference Rogers RW. A Protection Motivation Theory of Fear appeals and attitude Change1. J Psychol. 1975;91(1):93–114.CrossRefPubMed Rogers RW. A Protection Motivation Theory of Fear appeals and attitude Change1. J Psychol. 1975;91(1):93–114.CrossRefPubMed
25.
go back to reference Pashayan N, Morris S, Gilbert FJ, Pharoah PDP. Cost-effectiveness and benefit-to-harm ratio of risk-stratified screening for breast Cancer: a life-table model. JAMA Oncol. 2018;4(11):1504–10.CrossRefPubMedPubMedCentral Pashayan N, Morris S, Gilbert FJ, Pharoah PDP. Cost-effectiveness and benefit-to-harm ratio of risk-stratified screening for breast Cancer: a life-table model. JAMA Oncol. 2018;4(11):1504–10.CrossRefPubMedPubMedCentral
26.
go back to reference Rainey L, Jervaeus A, Donnelly LS, Evans DG, Hammarström M, Hall P, et al. Women’s perceptions of personalized risk-based breast cancer screening and prevention: an international focus group study. Psychooncology. 2019;28(5):1056–62.CrossRefPubMedPubMedCentral Rainey L, Jervaeus A, Donnelly LS, Evans DG, Hammarström M, Hall P, et al. Women’s perceptions of personalized risk-based breast cancer screening and prevention: an international focus group study. Psychooncology. 2019;28(5):1056–62.CrossRefPubMedPubMedCentral
27.
go back to reference McWilliams L, Woof VG, Donnelly LS, Howell A, Evans DG, French DP. Extending screening intervals for women at low risk of breast cancer: do they find it acceptable? BMC Cancer. 2021;21(1):637.CrossRefPubMedPubMedCentral McWilliams L, Woof VG, Donnelly LS, Howell A, Evans DG, French DP. Extending screening intervals for women at low risk of breast cancer: do they find it acceptable? BMC Cancer. 2021;21(1):637.CrossRefPubMedPubMedCentral
28.
go back to reference Edwards AG, Evans R, Dundon J, Haigh S, Hood K, Elwyn GJ. Personalised risk communication for informed decision making about taking screening tests. Cochrane Database Syst Rev. 2006(4):Cd001865. Edwards AG, Evans R, Dundon J, Haigh S, Hood K, Elwyn GJ. Personalised risk communication for informed decision making about taking screening tests. Cochrane Database Syst Rev. 2006(4):Cd001865.
29.
go back to reference Jensen LF, Pedersen AF, Andersen B, Vedsted P. Identifying specific non-attending groups in breast cancer screening–population-based registry study of participation and socio-demography. BMC Cancer. 2012;12:518.CrossRefPubMedPubMedCentral Jensen LF, Pedersen AF, Andersen B, Vedsted P. Identifying specific non-attending groups in breast cancer screening–population-based registry study of participation and socio-demography. BMC Cancer. 2012;12:518.CrossRefPubMedPubMedCentral
31.
go back to reference Hawkins M, Gill SD, Batterham R, Elsworth GR, Osborne RH. The health literacy questionnaire (HLQ) at the patient-clinician interface: a qualitative study of what patients and clinicians mean by their HLQ scores. BMC Health Serv Res. 2017;17(1):309.CrossRefPubMedPubMedCentral Hawkins M, Gill SD, Batterham R, Elsworth GR, Osborne RH. The health literacy questionnaire (HLQ) at the patient-clinician interface: a qualitative study of what patients and clinicians mean by their HLQ scores. BMC Health Serv Res. 2017;17(1):309.CrossRefPubMedPubMedCentral
Metadata
Title
Attitudes towards risk-stratified breast cancer screening: a population-based survey among 5,001 Danish women
Authors
Louise Hougaard Loft
Line Hjøllund Pedersen
Janne Bigaard
Stig Egil Bojesen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2024
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-024-12083-2

Other articles of this Issue 1/2024

BMC Cancer 1/2024 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine