Systematic review on women's values and preferences concerning breast cancer screening and diagnostic services
Por:
Mathioudakis, AG, Salakari, M, Pylkkanen, L, Saz-Parkinson, Z, Bramesfeld, A, Deandrea, S, Lerda, D, Neamtiu, L, Pardo-Hernandez, H, Sola, I, Alonso-Coello, P
Publicada:
1 may 2019
Resumen:
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.
Filiaciones:
Mathioudakis, AG:
Iberoamer Cochrane Ctr, Biomed Res Inst IIB St Pau, Barcelona, Spain
Univ Manchester, Fac Biol Med & Hlth, Div Infect Immun & Resp Med, Manchester, Lancs, England
Salakari, M:
Univ Turku, Fac Med, Dept Publ Hlth, Turku, Finland
Pylkkanen, L:
European Commiss, Joint Res Ctr, Via E Fermi 2749,TP127, I-21027 Ispra, VA, Italy
Finnish Med Agcy Fimea, Clinicopharmacol Unit, Turku, Finland
Saz-Parkinson, Z:
European Commiss, Joint Res Ctr, Via E Fermi 2749,TP127, I-21027 Ispra, VA, Italy
Bramesfeld, A:
European Commiss, Joint Res Ctr, Via E Fermi 2749,TP127, I-21027 Ispra, VA, Italy
Hannover Med Sch, Inst Epidemiol Social Med & Hlth Syst Res, Hannover, Germany
Deandrea, S:
European Commiss, Joint Res Ctr, Via E Fermi 2749,TP127, I-21027 Ispra, VA, Italy
Hlth Protect Agcy, Metropolitan City Milan, Italy
Lerda, D:
European Commiss, Joint Res Ctr, Via E Fermi 2749,TP127, I-21027 Ispra, VA, Italy
Neamtiu, L:
European Commiss, Joint Res Ctr, Via E Fermi 2749,TP127, I-21027 Ispra, VA, Italy
Pardo-Hernandez, H:
Iberoamer Cochrane Ctr, Biomed Res Inst IIB St Pau, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Sola, I:
Iberoamer Cochrane Ctr, Biomed Res Inst IIB St Pau, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Alonso-Coello, P:
Iberoamer Cochrane Ctr, Biomed Res Inst IIB St Pau, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Hybrid Gold, Green Published
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