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Grimm LJ, Avery CS, Hendrick E, Baker JA. Benefits and Risks of Mammography Screening in Women Ages 40 to 49 Years. J Prim Care Community Health 2022; 13:21501327211058322. [PMID: 35068237 PMCID: PMC8796062 DOI: 10.1177/21501327211058322] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Breast cancer screening in the United States is complicated by conflicting recommendations from professional and governmental organizations. The benefits and risks of breast cancer screening differ though by age which should influence shared decision-making discussions. Compared to older women, women ages 40 to 49 years have a lower risk of breast cancer, but the types of breast cancer that develop are often more aggressive with a poorer prognosis. Furthermore, younger women have a longer life expectancy and fewer comorbidities. The primary benefits of screening for women in their 40s are a reduction in breast cancer mortality, years of life lost to breast cancer, and morbidity of breast cancer treatment by detecting cancers at an earlier stage. Compared to older women, the risks of breast cancer screening in women ages 40 to 49 years includes more false positive recalls and biopsies as well as transient anxiety. Concerns regarding radiation induced malignancy and overdiagnosis are minimal in this age group. The shorter lead time of breast cancer in women ages 40 to 49 years also favors shorter screening intervals. This information should help inform providers in their shared decision-making discussions with patients.
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Affiliation(s)
| | | | | | - Jay A Baker
- Duke University Medical Center, Durham, NC, USA
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2
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Williamson SZ, Johnson R, Sandhu HK, Parsons N, Jenkins J, Casey M, Kearins O, Taylor-Phillips S. Communicating benign biopsy results by telephone in the NHS Breast Screening Programme: a protocol for a cluster randomised crossover trial. BMJ Open 2019; 9:e028679. [PMID: 31377704 PMCID: PMC6687008 DOI: 10.1136/bmjopen-2018-028679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 06/11/2019] [Accepted: 07/11/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION One of the main harms from breast cancer screening is the anxiety caused by false positive results. Various factors may be associated with false-positive anxiety. One modifiable factor may be the method of communication used to deliver results. The aim of this study is to measure the effect on anxiety of receiving benign biopsy results in-person or by telephone. METHODS AND ANALYSIS This is a multi-centre cluster randomised crossover trial in the English National Health Service Breast Screening Programme (NHSBSP) involving repeated survey measures at four time points. Participants will be women of screening age who have a biopsy following a suspicious mammography result, who ultimately receive a benign or normal (B1) result. Centres will trial both telephone and in-person results on a month-by-month basis, being randomised to which communication method will be trialled first. Women will be blinded to the method of communication they will receive. The analysis will compare women who have received telephone results and women who have received in-person results. The primary outcome measure will be anxiety (measured by the Psychological Consequences Questionnaire) after receiving results, while controlling for baseline anxiety. Secondary outcome measures will include anxiety at 3 and 6 months post-results, understanding of results and patient preferences for how results are communicated. Qualitative telephone interviews will also be conducted to further explore women's reasons for communication preferences. Qualitative and quantitative data will be integrated after initial separate analysis using the pillar integration process. ETHICS AND DISSEMINATION This study has been approved by the Public Health England Breast Screening Programme Research Advisory Committee, (BSPRAC_0013, ODR1718_040) and the National Health Service Health Research Authority (HRA) West Midlands-Coventry & Warwickshire Research Ethics Committee (17/WM/0313). The findings from this study will be disseminated to key stakeholders within the NHSBSP and via academic publications. TRIAL REGISTRATION NUMBER ISRCTN36997684 TRIAL SPONSOR: This research is part of a PhD award and is funded by the Economic and Social Research Council Doctoral Training Centre at the University of Warwick and Public Health England. The sponsor for this research is Jane Prewett (sponsorship@warwick.ac.uk).
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Affiliation(s)
- Sian Zena Williamson
- Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rebecca Johnson
- Faculty of Health & Life Sciences, University of Warwick, Coventry, UK
| | | | - Nicholas Parsons
- Statistics and Epidemiology, Warwick Medical School, University of Warwick, Coventry, UK
| | - Jacquie Jenkins
- National Programme Manager-NHS Breast Screening Programme, Public Health England, Sheffield, UK
| | - Margaret Casey
- Clinical Nurse Specialist Breast Care, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Olive Kearins
- National Lead Breast Screening QA, Public Health England, Birmingham, UK
| | - Sian Taylor-Phillips
- Population Evidence and Technologies, Warwick Medical School, University of Warwick, Coventry, UK
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Long H, Brooks JM, Harvie M, Maxwell A, French DP. How do women experience a false-positive test result from breast screening? A systematic review and thematic synthesis of qualitative studies. Br J Cancer 2019; 121:351-358. [PMID: 31332283 PMCID: PMC6738040 DOI: 10.1038/s41416-019-0524-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/24/2019] [Accepted: 06/28/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND This is the first review to identify, appraise and synthesise women's experiences of having a false-positive breast screening test result. METHODS We systematically searched eight databases for qualitative research reporting women's experiences of receiving a false-positive screening test result. Two reviewers independently screened articles. Eight papers reporting seven studies were included. Study quality was appraised. Data were thematically synthesised. RESULTS Women passively attended screening in order to prove their perceived good health. Consequently, being recalled was unexpected, shocking and disempowering: women felt without options. They endured great uncertainty and stress and sought clarity about their health (e.g. by scrutinising the wording of recall letters and conversations with healthcare professionals). Their result was accompanied by relief and welcome feelings of certainty about their health, but some received unclear explanations of their result, contributing to lasting breast cancer-related worry and an ongoing need for further reassurance. CONCLUSION The organisation of breast screening programmes may constrain choice for women: they became passive recipients. The way healthcare professionals verbally communicate results to women may contribute to lasting breast cancer-related worry. Women need more reassurance, emotional support and answers to their questions before and during screening assessment, and after receiving their result.
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Affiliation(s)
- Hannah Long
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, M13 9PL, United Kingdom.
| | - Joanna M Brooks
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, M13 9PL, United Kingdom
| | - Michelle Harvie
- Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, United Kingdom
| | - Anthony Maxwell
- Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, United Kingdom
- Division of Informatics, Imaging & Data Sciences, School of Health Sciences, University of Manchester, Manchester, M13 9PT, United Kingdom
| | - David P French
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, M13 9PL, United Kingdom
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4
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Matters of fact and politics: Generating expectations of cancer screening. Soc Sci Med 2019; 232:408-416. [PMID: 31151027 DOI: 10.1016/j.socscimed.2019.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 05/11/2019] [Accepted: 05/16/2019] [Indexed: 11/20/2022]
Abstract
Many countries, including Australia, the United Kingdom and the United States have established national screening programs in the effort to advance the early diagnosis of cancers. Australia has population screening programs for breast, bowel and cervical cancers, and this article focuses on breast and cervical cancer screening as the two longest running programs in Australia. While these screening programs are well-established and report relatively high participation rates, the effectiveness of population screening is a contested issue, subject to significant, ongoing debate about its purported benefits (Armstrong, 2019). In this article, we draw on ideas from sociology of science on the construction of scientific facts to analyse how evidentiary claims are presented in policy documents for Australia's breast and cervical cancer screening programs, and the implications for those who are the targets of screening. We explore how screening-related information assumes the status of scientific 'facts', and argue that presenting information as neutral and objective obscures the political choices involved in its generation. Importantly, some of the claims presented in the policy documents have a tendency to emphasise the benefits, and minimise the risks and harms of population-based screening. In doing so, we suggest that the current national policies may be contributing to sustaining expectations of screening that are higher than warranted. Higher expectations may bring with them unintended societal and economic costs to the public. We conclude by noting how deeply ingrained socio-cultural meanings of cancer shape public expectations of the protective value of screening, which allows current screening approaches to become further entrenched and resistant to challenge.
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Broholm-Jørgensen M, Kamstrup-Larsen N, Guassora AD, Reventlow S, Dalton SO, Tjørnhøj-Thomsen T. ‘It can’t do any harm’: A qualitative exploration of accounts of participation in preventive health checks. HEALTH RISK & SOCIETY 2019. [DOI: 10.1080/13698575.2019.1602251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Nina Kamstrup-Larsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ann Dorrit Guassora
- The research Unit and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Reventlow
- The research Unit and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Danish Cancer Society Research Center, Survivorship, Copenhagen, Denmark
- Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Næstved, Denmark
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Solbjør M, Forsmo S, Skolbekken JA, Siersma V, Brodersen J. Psychosocial consequences among women with false-positive results after mammography screening in Norway. Scand J Prim Health Care 2018; 36:380-389. [PMID: 30296861 PMCID: PMC6381538 DOI: 10.1080/02813432.2018.1523985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Mammography screening may cause psychosocial harm for women experiencing a false-positive screening result. Previous studies suggest long-term consequences. The aim of the present study was to assess psychosocial consequences of false-positive findings on screening mammography within a six month follow-up. METHODS A prospective matched cohort survey study using the questionnaire 'Consequences of Screening for Breast Cancer' (COS-BC), which was translated from Danish to Norwegian. Psychometric analyses investigated the measurement properties of the Norwegian version. Two screening clinics in Norway distributed the survey to 299 women with an abnormal mammogram and 541 women with a normal screen. Women received the questionnaire when receiving the screening result, and one and six months after screening. RESULTS At six months, statistically significant differences appeared in two scales: existential values and breast examination. At six-month follow-up, women with false-positive results showed no statistically significant differences from women diagnosed with breast cancer in three outcomes: sense of dejection, anxiety, and keeping my mind off things. CONCLUSION Our results indicate that the psychosocial consequences from having false-positive screening mammography results diminish after six months. The results support previous research describing breast-specific outcomes. However, our results indicate that Norwegian women are less frightened than other Scandinavian mammography screening participants.
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Affiliation(s)
- Marit Solbjør
- Department of Public Health and Nursing, Trondheim, Norway;
- CONTACT Marit Solbjør Department of Public Health and Nursing, P.O. Box 8905, N-7491, Trondheim, Norway
| | - Siri Forsmo
- Department of Public Health and Nursing, Trondheim, Norway;
| | | | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;
| | - John Brodersen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;
- Primary Health Care Research Unit, Region Zealand, Denmark
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W. Jacobsen G. Falsk alarm. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2017; 137:85. [DOI: 10.4045/tidsskr.17.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Pauwels EK, Foray N, Bourguignon MH. Breast Cancer Induced by X-Ray Mammography Screening? A Review Based on Recent Understanding of Low-Dose Radiobiology. Med Princ Pract 2016; 25:101-9. [PMID: 26571215 PMCID: PMC5588356 DOI: 10.1159/000442442] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 11/15/2015] [Indexed: 12/28/2022] Open
Abstract
Screening mammography offers the possibility of discovering malignant diseases at an early stage, which is consequently treated early, thereby reducing the mortality rate. However, ionizing radiation as used in low-dose X-ray mammography may be associated with a risk of radiation-induced carcinogenesis. In the context of the harmful effects of ionizing radiation, this article reviewed novel radiobiological data and provided a simulation of the relative incidence of radiation-induced breast cancer due to screening against a background baseline incidence in a population of 100,000 individuals. The use of modern digital mammographic technology was assumed, giving rise to a glandular dose of 2.5 mGy from a 2-view per breast image. Assuming no latency time, this led to a ratio of induced incidence rate over baseline incidence rate of about 1.6‰ for biennial screening in women aged 50-74 years, although it cannot be excluded that the dose and dose rate effectiveness factor values relying on new radiobiological insights may lower this number to about 0.7‰. This carcinogenic risk is considered small in relation to the potential beneficial effects of screening, especially as latency time was not taken into consideration. However, individuals who are known to be carriers of risk-increasing genetic variations and/or have an inherited disposition of breast cancer should avoid ionizing radiation as much as possible and should be referred to ultrasound or magnetic resonance imaging. In addition, a significant, but difficult to quantify, risk of cancer is present for individuals who suffer from hypersusceptibility to ionizing radiation.
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Affiliation(s)
- Ernest K.J. Pauwels
- Department of Radiology, University Medical Center Leiden, Leiden
- Department of Nuclear Medicine, University Medical School Pisa, Pisa, Italy
- *Prof. emer. Dr. E.K.J. Pauwels, Department of Radiology and Nuclear Medicine, Via di San Gennaro 79B, IT—55010 Capannori (Italy), E-Mail
| | - Nicolas Foray
- Department of Radiobiology INSERM, UMR1052, Cancer Research Centre of Lyon, Lyon
| | - Michel H. Bourguignon
- Department of Biophysics, University of Versailles, Paris, France
- Institut de Radioprotection et de Sureté Nucléaire, Fontenay-aux-Roses, France
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Solbjør M, Skolbekken JA, Østerlie W, Forsmo S. Women's Experiences With Mammography Screening Through 6 Years of Participation--A Longitudinal Qualitative Study. Health Care Women Int 2015; 36:558-77. [PMID: 25510784 DOI: 10.1080/07399332.2014.989438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this article we explore women's experiences with 6 years of mammography screening. Regular and repeated mammography screening is promoted as an important tool for disease prevention among women worldwide. The purpose of the present study was to explore how continued participation in screening influences how women perceive screening and breast cancer. We carried out focus groups with 24 screening participants in 2003 and 2009. Our analysis highlights that while women were excited about the examination in 2003, it was perceived as routine in 2009. Waiting for the results became easier over the years, while stress related to receiving the results letter did not diminish. Knowledge of risk factors for breast cancer did not change. Personal risk assessment remained low, though high incidence of cancer among acquaintances suggested high risk for breast cancer among women in general. Analysis of participant experiences suggests that continuous participation in screening has led surveillance medicine to become a part of ordinary life.
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Affiliation(s)
- Marit Solbjør
- a Department of Social Work and Health Science, Norwegian University of Science and Technology , Trondheim , Norway
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Women's experiences of the breast cancer diagnostic process: A thematic evaluation of the literature; Recall & biopsy. Radiography (Lond) 2015. [DOI: 10.1016/j.radi.2014.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Clark S, Reeves PJ. Women's experiences of mammography: A thematic evaluation of the literature. Radiography (Lond) 2015. [DOI: 10.1016/j.radi.2014.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Thomson MD, Siminoff LA. Perspectives on mammography after receipt of secondary screening owing to a false positive. Womens Health Issues 2015; 25:128-33. [PMID: 25648490 DOI: 10.1016/j.whi.2014.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 11/04/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The utility of mammography screening as an efficacious tool for early detection is being contested owing to the risk of potential harms, including psychological distress and exposure to unnecessary procedures associated with false-positive (FPs) results and overdiagnosis. However, there is little research regarding women's experiences, values, or preferences for participating in mammography programs. Our aim was to explore women's actual experiences of a FP mammography screen and their perceptions of the value, risks and benefits given their recent experience. METHODS We conducted semistructured interviews with 40 women who experienced a recent FP mammogram. Interviews were recorded and transcribed verbatim. A directed content analysis was used to identify and explore primary themes. Knowledge of breast cancer risk was also assessed. FINDINGS Receiving a FP mammography screen generated significant worry among 60% (n=24) of women. Yet 70% maintained that mammography screening was necessary despite the worry incurred. Women also described the experience as stimulating greater interest in additional cancer prevention activities (32.5%; n=13) and one-third discussed needing more information about the risks and benefits of mammography screening. Less than one-quarter of women (22.5%; n=9) correctly identified a women's lifetime risk of developing breast cancer; 20% (n=8) overestimated, and 57.5% (n=23) underestimated this risk. CONCLUSION Women reported needing more information about the risks and benefits of mammography screening, but also considered FP results an acceptable risk. Further, our results suggest that breast cancer screening programs may provide a unique opportunity to deliver additional breast cancer prevention interventions.
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Affiliation(s)
- Maria D Thomson
- Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, Virginia.
| | - Laura A Siminoff
- Dean and Laura H. Carnell Professor of Public Health in the College of Health Professions and Social Work, Temple University, Philadelphia, Pennsylvania
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Bolejko A, Zackrisson S, Hagell P, Wann-Hansson C. A roller coaster of emotions and sense--coping with the perceived psychosocial consequences of a false-positive screening mammography. J Clin Nurs 2013; 23:2053-62. [PMID: 24313329 DOI: 10.1111/jocn.12426] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2013] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore coping with the perceived psychosocial consequences of a false-positive screening mammography. BACKGROUND Mammographic screening has been found effective to decrease breast cancer (BC) mortality, yet there are adverse effects. Psychosocial consequences of false-positive mammographic screening have mainly been investigated from a population-based perspective. A call for qualitative studies to further explore these consequences has thus been postulated. To date, qualitative studies have elucidated women's experiences following their recall breast examinations, but their coping with perceived psychosocial consequences of a false-positive screening mammography has not yet been explored. DESIGN An explorative qualitative study. METHODS Face-to-face interviews were held with a purposive heterogeneous sample of 13 Swedish-speaking women with a false-positive screening mammography. The transcripts were analysed by the use of an inductive content analysis. RESULTS Coping with the perceived psychosocial consequences of a false-positive screening mammography implied a roller coaster of emotion and sense. Women described how they imagined the worst and were in a state of uncertainty feeling threatened by a fatal disease. Conversely, they felt protected, surrounded by their families and being professionally taken care of, which together with perceived sisterhood and self-empowerment evoked strength and hope. Being aware of family responsibility became a crucial matter. Experiencing false-positive screening raised thoughts of thankfulness and reappraisal of life, although an ounce of BC anxiety remained. Consequently, gained awareness about BC screening and values in life surfaced. CONCLUSIONS Experiencing a false-positive screening mammography triggers agonising experiences evoking a variety of coping strategies. Provision of screening raises the issue of responsibility for an impact on psychosocial well-being among healthy women. RELEVANCE TO CLINICAL PRACTICE Gained knowledge might provide a basis for interventions to prevent psychosocial consequences of false-positive mammographic screening and provide support for women with a potentially compromised ability to overcome such consequences.
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Affiliation(s)
- Anetta Bolejko
- Department of Health Sciences, Lund University, Lund, Sweden; Diagnostic Centre of Imaging and Functional Medicine, Skåne University Hospital Malmö, Malmö, Sweden
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Lindberg LG, Svendsen M, Dømgaard M, Brodersen J. Better safe than sorry: a long-term perspective on experiences with a false-positive screening mammography in Denmark. HEALTH RISK & SOCIETY 2013. [DOI: 10.1080/13698575.2013.848845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Sherman KA, Winch CJ, Borecky N, Boyages J. Psychological distress and streamlined BreastScreen follow‐up assessment versus standard assessment. Med J Aust 2013; 199:599-603. [PMID: 24182225 DOI: 10.5694/mja13.10112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 08/06/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Kerry A Sherman
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW
| | - Caleb J Winch
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW
| | - Natacha Borecky
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW
| | - John Boyages
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW
- Macquarie University Cancer Institute, Macquarie University, Sydney, NSW
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Solbjør M, Skolbekken JA, Sætnan AR, Hagen AI, Forsmo S. Mammography screening and trust: the case of interval breast cancer. Soc Sci Med 2012; 75:1746-52. [PMID: 22906524 DOI: 10.1016/j.socscimed.2012.07.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 07/17/2012] [Accepted: 07/20/2012] [Indexed: 11/30/2022]
Abstract
Interval cancer is cancer detected between screening rounds among screening participants. In the Norwegian Breast Cancer Screening Programme, 19 per 10,000 screened women are diagnosed with interval cancer. We conducted semi-structured interviews with 26 such women. The women interpreted their interval breast cancer in two ways: that mammography can never be completely certain, or as an experience characterized by shock and doubts about the technology and the conduct of the medical experts. Being diagnosed with interval cancer thus influenced their trust in mammography, but not necessarily to the point of creating distrust. The women saw themselves as exceptions in an otherwise beneficial screening programme. Convinced that statistics had shown benefits from mammography screening and knowing others whose malignant tumours had been detected in the programme, the women bracketed their own experiences and continued trusting mammography screening. Facing a potentially lethal disease and a lack of alternatives to mammography screening left the women with few options but to trust the programme in order to maintain hope. In other words, trust may not only be a basis for hope, but also a consequence of it.
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Affiliation(s)
- Marit Solbjør
- Norwegian University of Science and Technology, Medical Faculty, Department of Public Health and General Practice, Postbox 8905, MTFS, 7491 Trondheim, Norway.
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