Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice
Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a random...
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doaj-5411a1ac6670493cbb74bcdadc9588832020-11-24T20:42:21ZengHindawi LimitedJournal of Cancer Epidemiology1687-85581687-85662012-01-01201210.1155/2012/835167835167Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical PracticeLindsay J. L. Forbes0Alice S. Forster1Rachael H. Dodd2Lorraine Tucker3Rachel Laming4Sarah Sellars5Julietta Patnick6Amanda J. Ramirez7Promoting Early Presentation Group, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Capital House, 42 Weston Street, London SE1 3QD, UKPromoting Early Presentation Group, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Capital House, 42 Weston Street, London SE1 3QD, UKPromoting Early Presentation Group, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Capital House, 42 Weston Street, London SE1 3QD, UKPromoting Early Presentation Group, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Capital House, 42 Weston Street, London SE1 3QD, UKPromoting Early Presentation Group, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Capital House, 42 Weston Street, London SE1 3QD, UKNHS Cancer Screening Programmes, Fulwood House, Old Fulwood Road, Sheffield S10 3TH, UKNHS Cancer Screening Programmes, Fulwood House, Old Fulwood Road, Sheffield S10 3TH, UKPromoting Early Presentation Group, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Capital House, 42 Weston Street, London SE1 3QD, UKBackground. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women.http://dx.doi.org/10.1155/2012/835167 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lindsay J. L. Forbes Alice S. Forster Rachael H. Dodd Lorraine Tucker Rachel Laming Sarah Sellars Julietta Patnick Amanda J. Ramirez |
spellingShingle |
Lindsay J. L. Forbes Alice S. Forster Rachael H. Dodd Lorraine Tucker Rachel Laming Sarah Sellars Julietta Patnick Amanda J. Ramirez Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice Journal of Cancer Epidemiology |
author_facet |
Lindsay J. L. Forbes Alice S. Forster Rachael H. Dodd Lorraine Tucker Rachel Laming Sarah Sellars Julietta Patnick Amanda J. Ramirez |
author_sort |
Lindsay J. L. Forbes |
title |
Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice |
title_short |
Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice |
title_full |
Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice |
title_fullStr |
Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice |
title_full_unstemmed |
Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice |
title_sort |
promoting early presentation of breast cancer in older women: implementing an evidence-based intervention in routine clinical practice |
publisher |
Hindawi Limited |
series |
Journal of Cancer Epidemiology |
issn |
1687-8558 1687-8566 |
publishDate |
2012-01-01 |
description |
Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women. |
url |
http://dx.doi.org/10.1155/2012/835167 |
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