Premium
Systematic review on women's values and preferences concerning breast cancer screening and diagnostic services
Author(s) -
Mathioudakis Alexander G.,
Salakari Minna,
Pylkkanen Liisa,
SazParkinson Zuleika,
Bramesfeld Anke,
Deandrea Silvia,
Lerda Donata,
Neamtiu Luciana,
PardoHernandez Hector,
Solà Ivan,
AlonsoCoello Pablo
Publication year - 2019
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.5041
Subject(s) - overdiagnosis , medicine , breast cancer screening , breast cancer , mammography , context (archaeology) , harm , medline , anxiety , cancer screening , thematic analysis , family medicine , qualitative research , clinical psychology , gynecology , psychiatry , psychology , cancer , social psychology , pathology , paleontology , social science , sociology , political science , law , biology
Background 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 . Methods 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. Results 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. Conclusions 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.