Introducing a low-risk breast screening pathway into the NHS Breast Screening Programme: Views from healthcare professionals who are delivering risk-stratified screening
Objectives: Proposals to stratify breast screening by breast cancer risk aim to produce a better balance of benefits to harms. Notably, risk estimation calculated from common risk factors and a polygenic risk score would enable high-risk women to benefit from more frequent screening or preventive me...
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doaj-776e0c8b02104a4491d6241f99b270602021-04-20T22:03:42ZengSAGE PublishingWomen's Health1745-50652021-04-011710.1177/17455065211009746Introducing a low-risk breast screening pathway into the NHS Breast Screening Programme: Views from healthcare professionals who are delivering risk-stratified screeningVictoria G Woof0Lorna McWilliams1Louise S Donnelly2Anthony Howell3D Gareth Evans4Anthony J Maxwell5David P French6Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester, UKManchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester, UKNIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Mental Health and Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester, UKNightingale and Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust, Manchester, UKDepartment of Genomic Medicine, Division of Evolution and Genomic Science, University of Manchester, MAHSC, Manchester University NHS Foundation Trust, Manchester, UKDivision of Informatics, Imaging & Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UKManchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester, UKObjectives: Proposals to stratify breast screening by breast cancer risk aim to produce a better balance of benefits to harms. Notably, risk estimation calculated from common risk factors and a polygenic risk score would enable high-risk women to benefit from more frequent screening or preventive medication. This service would also identify low-risk women who experience fewer benefits from attending, as lower grade and in situ cancers may be treated unnecessarily. It may therefore be appropriate for low-risk women to attend screening less. This study aimed to elicit views regarding implementing less frequent screening for low-risk women from healthcare professionals who implement risk-stratified screening. Methods: Healthcare professionals involved in the delivery of risk-stratified breast screening were invited to participate in a focus group within the screening setting in which they work or have a telephone interview. Primary care staff were also invited to provide their perspective. Three focus groups and two telephone interviews were conducted with 28 healthcare professionals. To identify patterns across the sample, data were analysed as a single dataset using reflexive thematic analysis. Results: Analysis yielded three themes: Reservations concerning the introduction of less frequent screening , highlighting healthcare professionals’ unease and concerns towards implementing less frequent screening; Considerations for the management of public knowledge , providing views on media impact on public opinion and the potential for a low-risk pathway to cause confusion and raise suspicion regarding implementation motives; and Deliberating service implications and reconfiguration management , where the practicalities of implementation are discussed. Conclusions: Healthcare professionals broadly supported less frequent screening but had concerns about implementation. It will be essential to address concerns regarding risk estimate accuracy, healthcare professional confidence, service infrastructure and public communication prior to introducing less frequent screening for low-risk women.https://doi.org/10.1177/17455065211009746 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Victoria G Woof Lorna McWilliams Louise S Donnelly Anthony Howell D Gareth Evans Anthony J Maxwell David P French |
spellingShingle |
Victoria G Woof Lorna McWilliams Louise S Donnelly Anthony Howell D Gareth Evans Anthony J Maxwell David P French Introducing a low-risk breast screening pathway into the NHS Breast Screening Programme: Views from healthcare professionals who are delivering risk-stratified screening Women's Health |
author_facet |
Victoria G Woof Lorna McWilliams Louise S Donnelly Anthony Howell D Gareth Evans Anthony J Maxwell David P French |
author_sort |
Victoria G Woof |
title |
Introducing a low-risk breast screening pathway into the NHS Breast Screening Programme: Views from healthcare professionals who are delivering risk-stratified screening |
title_short |
Introducing a low-risk breast screening pathway into the NHS Breast Screening Programme: Views from healthcare professionals who are delivering risk-stratified screening |
title_full |
Introducing a low-risk breast screening pathway into the NHS Breast Screening Programme: Views from healthcare professionals who are delivering risk-stratified screening |
title_fullStr |
Introducing a low-risk breast screening pathway into the NHS Breast Screening Programme: Views from healthcare professionals who are delivering risk-stratified screening |
title_full_unstemmed |
Introducing a low-risk breast screening pathway into the NHS Breast Screening Programme: Views from healthcare professionals who are delivering risk-stratified screening |
title_sort |
introducing a low-risk breast screening pathway into the nhs breast screening programme: views from healthcare professionals who are delivering risk-stratified screening |
publisher |
SAGE Publishing |
series |
Women's Health |
issn |
1745-5065 |
publishDate |
2021-04-01 |
description |
Objectives: Proposals to stratify breast screening by breast cancer risk aim to produce a better balance of benefits to harms. Notably, risk estimation calculated from common risk factors and a polygenic risk score would enable high-risk women to benefit from more frequent screening or preventive medication. This service would also identify low-risk women who experience fewer benefits from attending, as lower grade and in situ cancers may be treated unnecessarily. It may therefore be appropriate for low-risk women to attend screening less. This study aimed to elicit views regarding implementing less frequent screening for low-risk women from healthcare professionals who implement risk-stratified screening. Methods: Healthcare professionals involved in the delivery of risk-stratified breast screening were invited to participate in a focus group within the screening setting in which they work or have a telephone interview. Primary care staff were also invited to provide their perspective. Three focus groups and two telephone interviews were conducted with 28 healthcare professionals. To identify patterns across the sample, data were analysed as a single dataset using reflexive thematic analysis. Results: Analysis yielded three themes: Reservations concerning the introduction of less frequent screening , highlighting healthcare professionals’ unease and concerns towards implementing less frequent screening; Considerations for the management of public knowledge , providing views on media impact on public opinion and the potential for a low-risk pathway to cause confusion and raise suspicion regarding implementation motives; and Deliberating service implications and reconfiguration management , where the practicalities of implementation are discussed. Conclusions: Healthcare professionals broadly supported less frequent screening but had concerns about implementation. It will be essential to address concerns regarding risk estimate accuracy, healthcare professional confidence, service infrastructure and public communication prior to introducing less frequent screening for low-risk women. |
url |
https://doi.org/10.1177/17455065211009746 |
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