Systematic review on women's values and preferences concerning breast cancer screening and diagnostic services
Mathioudakis, Alexander G. (University of Manchester)
Salakari, Minna (University of Turku)
Pylkkanen, Liisa (Finnish Medicines Agency Fimea)
Saz-Parkinson, Zuleika (European Commission)
Bramesfeld, Anke (Hanover Medical School)
Deandrea, Silvia (Health Protection Agency of Pavia)
Lerda, Donata (European Commission)
Neamtiu, L. (European Commission)
Pardo-Hernandez, Héctor (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Solà, Ivan (Institut d'Investigació Biomèdica Sant Pau)
Alonso-Coello, Pablo (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Date:	2019
Abstract:	There is still lack of consensus on the benefit-harm balance of breast cancer screening. In this scenario, women's values and preferences are crucial for developing health-related recommendations. In the context of the European Commission Initiative on Breast Cancer, we conducted a systematic review to inform the European Breast Guidelines. We searched Medline and included primary studies assessing women's values and preferences regarding breast cancer screening and diagnosis decision making. We used a thematic approach to synthesise relevant data. The quality of evidence was determined with GRADE, including GRADE CERQual for qualitative research. We included 22 individual studies. Women were willing to accept the psychological and physical burden of breast cancer screening and a significant risk of overdiagnosis and false-positive mammography findings, in return for the benefit of earlier diagnosis. The anxiety engendered by the delay in getting results of diagnostic tests was highlighted as a significant burden, emphasising the need for rapid and efficient screening services, and clear and efficient communication. The confidence in the findings was low to moderate for screening and moderate for diagnosis, predominantly because of methodological limitations, lack of adequate understanding of the outcomes by participants, and indirectness. Women value more the possibility of an earlier diagnosis over the risks of a false-positive result or overdiagnosis. Concerns remain that women may not understand the concept of overdiagnosis. Women highly value time efficient screening processes and rapid result delivery and will accept some discomfort for the peace of mind screening may provide.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Breast cancer ; Cancer ; Diagnostic services ; Oncology ; Patient preference ; Patient-centred care ; Practice guideline ; Screening
Published in:	Psycho-Oncology, Vol. 28 Núm. 5 (may 2019) , p. 939-947, ISSN 1099-1611

DOI: 10.1002/pon.5041
PMID: 30812068

9 p, 372.6 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles