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UK Women's views of the Concepts of Personalised Breast Cancer Risk Assessment and Risk-Stratified Breast Screening: A qualitative interview study

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Article number5813
Issue number22
Published19 Nov 2021

Bibliographical note

Funding Information: Funding: This research was funded by Breast Cancer Now, grant number 2018BCNNovPhD12651. Dr Jo Waller is funded by a Cancer Research UK Career Development Fellowship (C7492/A17219). Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

King's Authors


Any introduction of risk-stratification within the NHS Breast Screening Programme needs to be considered acceptable by women. We conducted interviews to explore women’s attitudes to personalised risk assessment and risk-stratified breast screening. Twenty-five UK women were purposively sampled by screening experience and socioeconomic background. Interview transcripts were qualitatively analysed using Framework Analysis. Women expressed positive intentions for personal risk assessment and willingness to receive risk feedback to provide reassurance and certainty. Women responded to risk-stratified screening scenarios in three ways: ‘Overall acceptors’ considered both high- and low-risk options acceptable as a reasonable allocation of resources to clinical need, yet acceptability was subject to specified conditions including accuracy of risk estimates and availability of support throughout the screening pathway. Others who thought ‘more is better’ only supported high-risk scenarios where increased screening was proposed. ‘Screening sceptics’ found low-risk scenarios more aligned to their screening values than high-risk screening options. Consideration of screening recommendations for other risk groups had more influence on women’s responses than screening-related harms. These findings demonstrate high, but not universal, acceptability. Support and guidance, tailored to screening values and preferences, may be required by women at all levels of risk.

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