Increased knowledge of breast cancer risk factors has meant that we are currently exploring risk-based screening, i.e. determining screening strategies based on women’s varying levels of risk. This also enables risk management through primary prevention strategies, e.g. a lifestyle programme or risk-reducing medication. However, future implementation of risk-based screening and prevention will warrant significant changes in current practice and policy. The present study explores women’s perceptions of the implementation and organisation of risk-based breast cancer screening and prevention to optimise acceptability and uptake. A total of 143 women eligible for breast cancer screening in the Netherlands, the United Kingdom, and Sweden participated in focus group discussions. The focus group discussions were transcribed verbatim and the qualitative data was analysed using thematic analysis. Women from all three countries generally agreed on the overall proceedings, e.g. a risk assessment after which the risk estimate is communicated via letter (for below average and average risk) or consultation (for moderate and high risk). However, discrepancies in information needs, preferred risk communication format and risk counselling professional were identified between countries. Additionally, a need to educate healthcare professionals on all aspects of the risk-based screening and prevention programme was established. Women’s insights identified the need for country-specific standardised protocols regarding the assessment and communication of risk, and the provision of heterogeneous screening and prevention recommendations, monitoring the principle of solidarity in healthcare policy.

中文翻译：

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欧洲妇女对基于风险的乳腺癌筛查和预防的实施和组织的看法：定性研究

对乳腺癌危险因素的了解增加，意味着我们目前正在探索基于风险的筛查，即根据女性不同的风险水平确定筛查策略。这也可以通过一级预防策略（例如，生活方式计划或降低风险的药物）进行风险管理。但是，基于风险的筛查和预防的未来实施将保证当前的实践和政策发生重大变化。本研究探讨了妇女对基于风险的乳腺癌筛查和预防的实施和组织方式的看法，以优化可接受性和摄取率。荷兰，英国和瑞典共有143名符合乳腺癌筛查条件的妇女参加了焦点小组讨论。焦点小组的讨论逐字记录，并使用主题分析对定性数据进行分析。来自所有三个国家的妇女总体上都同意整个程序，例如，进行风险评估，然后通过信函（针对低于平均水平和平均风险）或咨询（针对中度和高风险）传达风险估计。但是，国家之间发现了信息需求，偏好的风险交流格式和风险咨询专业人员之间的差异。此外，还需要对医疗专业人员进行基于风险的筛查和预防计划的所有方面的教育。妇女的见解确定了关于风险评估和交流以及提供不同筛查和预防建议的针对特定国家的标准化协议的必要性，