Abstract
BackgroundThe Predicting Risk of Cancer at Screening (PROCAS) study provided women who were eligible for breast cancer screening in Greater Manchester (United Kingdom) with their 10-year risk of breast cancer, i.e., low (≤1.5%), average (1.5–4.99%), moderate (5.-7.99%) or high (≥8%). The aim of this study is to explore which factors were associated with women’s uptake of screening and prevention recommendations. Additionally, we evaluated women’s organisational preferences regarding tailored screening.MethodsA total of 325 women with a self-reported low (n = 60), average (n = 125), moderate (n = 80), or high (n = 60) risk completed a two-part web-based survey. The first part contained questions about personal characteristics. For the second part women were asked about uptake of early detection and preventive behaviours after breast cancer risk communication. Additional questions were posed to explore preferences regarding the organisation of risk-stratified screening and prevention. We performed exploratory univariable and multivariable regression analyses to assess which factors were associated with uptake of primary and secondary breast cancer preventive behaviours, stratified by breast cancer risk. Organisational preferences are presented using descriptive statistics.ResultsSelf-reported breast cancer risk predicted uptake of (a) supplemental screening and breast self-examination, (b) risk-reducing medication and (c) preventive lifestyle behaviours. Further predictors were (a) having a first degree relative with breast cancer, (b) higher age, and (c) higher body mass index (BMI). Women’s organisational preferences for tailored screening emphasised a desire for more intensive screening for women at increased risk by further shortening the screening interval and moving the starting age forward.ConclusionsBreast cancer risk communication predicts the uptake of key tailored primary and secondary preventive behaviours. Effective communication of breast cancer risk information is essential to optimise the population-wide impact of tailored screening.
Highlights
The Predicting Risk of Cancer at Screening (PROCAS) study provided women who were eligible for breast cancer screening in Greater Manchester (United Kingdom) with their 10-year risk of breast cancer, i.e., low (≤1.5%), average (1.5–4.99%), moderate (5.-7.99%) or high (≥8%)
In the United Kingdom (UK), the National Health Service Breast Screening Programme (NHSBSP) offers triennial mammography screening to women aged 50–70 years [1]
The Predicting Risk of Cancer at Screening (PROCAS) study has shown that breast cancer risk assessment is feasible within the breast cancer screening setting of Greater Manchester, England [3]
Summary
The Predicting Risk of Cancer at Screening (PROCAS) study provided women who were eligible for breast cancer screening in Greater Manchester (United Kingdom) with their 10-year risk of breast cancer, i.e., low (≤1.5%), average (1.5–4.99%), moderate (5.-7.99%) or high (≥8%). To assess breast cancer risk, up to three sources of information were collected amongst 53,000 women between 2009 and 2013, i.e., (a) self-reported information on family history of breast cancer, parity, body mass index (BMI), height, age at menarche/menopause/first live birth, menopause hormone therapy use, (b) mammographic density, and (c) single-nucleotide polymorphisms (SNPs) derived from saliva. With this information, women could be classified as low, average, moderate, or high risk of developing breast cancer within the 10 years using the TyrerCuzick (TC) risk prediction model [4]. All risk categories were recommended to maintain a healthy lifestyle characterised by limited alcohol intake, a Mediterranean diet, and physical activity levels in line with cancer prevention guidance [6]
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