Health professionals’ perspectives on breast cancer risk stratification: understanding evaluation of risk versus screening for disease
Abstract Background Younger women at higher-than-population-average risk for breast cancer may benefit from starting screening earlier than presently recommended by the guidelines. The Personalized Risk Stratification for Prevention and Early Detection of Breast Cancer (PERSPECTIVE) approach aims to...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-02-01
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| Series: | Public Health Reviews |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40985-019-0111-5 |
| _version_ | 1831591679059034112 |
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| author | Svetlana Puzhko Justin Gagnon Jacques Simard Bartha Maria Knoppers Sophia Siedlikowski Gillian Bartlett |
| author_facet | Svetlana Puzhko Justin Gagnon Jacques Simard Bartha Maria Knoppers Sophia Siedlikowski Gillian Bartlett |
| author_sort | Svetlana Puzhko |
| collection | DOAJ |
| description | Abstract Background Younger women at higher-than-population-average risk for breast cancer may benefit from starting screening earlier than presently recommended by the guidelines. The Personalized Risk Stratification for Prevention and Early Detection of Breast Cancer (PERSPECTIVE) approach aims to improve the prevention of breast cancer through differential screening recommendations based on a personal risk estimate. In our study, we used deliberative stakeholder consultations to engage health professionals in an in-depth dialog to explore the feasibility of the proposed implementation strategies for this new personalized breast cancer screening approach. Methods Deliberative stakeholder consultation is a qualitative descriptive study design used to engage health professionals in the discussion, while the mediators play a more passive role. A purposeful sample of 11 health professionals (family physicians and genetic counselors) working in Montreal was used. The deliberations were organized in two phases, including small group deliberations according to the deliberants’ health profession and a mixed group deliberation combining participants from the small groups. Inductive thematic content analysis was performed on the transcripts by two coders to create the deliberative and analytic outputs. Quality of deliberations was assessed quantitatively using the de Vries method and qualitatively using participant observation. Results One of our key findings was that health professionals lacked understanding of the two steps of the screening approach: risk stratification “screening,” which is an evaluation for the level of risk and screening for disease. As part of this confusion, the main topic of concern was a justification of program implementation as a population-wide screening, based on their uncertainty that it will be beneficial for women with near-population risks. Despite the noted difficulties concerning implementation, health professionals acknowledged the substantial benefits of the proposed PERSPECTIVE program. Conclusions Our study was the first to evaluate the perspectives of health professionals on the implementation and benefits of a new program for breast cancer risk stratification with the purpose of personalizing screening for disease. This new multi-step approach to screening requires more clarity in communication with health professionals. To implement and maintain effective screening, engagement of family physicians with other health professionals or even development of a centralized public health system may be needed. |
| first_indexed | 2024-12-18T01:29:37Z |
| format | Article |
| id | doaj.art-508dd73a3704418ba667e5730cad57ab |
| institution | Directory Open Access Journal |
| issn | 2107-6952 |
| language | English |
| last_indexed | 2024-12-18T01:29:37Z |
| publishDate | 2019-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Public Health Reviews |
| spelling | doaj.art-508dd73a3704418ba667e5730cad57ab2022-12-21T21:25:38ZengFrontiers Media S.A.Public Health Reviews2107-69522019-02-0140111910.1186/s40985-019-0111-5Health professionals’ perspectives on breast cancer risk stratification: understanding evaluation of risk versus screening for diseaseSvetlana Puzhko0Justin Gagnon1Jacques Simard2Bartha Maria Knoppers3Sophia Siedlikowski4Gillian Bartlett5Department of Family Medicine, Faculty of Medicine, McGill UniversityDepartment of Family Medicine, Faculty of Medicine, McGill UniversityGenomics Center, CHU de Québec-Université Laval Research CenterGenome Quebec Innovation Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine, McGill UniversityDepartment of Family Medicine, Faculty of Medicine, McGill UniversityDepartment of Family Medicine, Faculty of Medicine, McGill UniversityAbstract Background Younger women at higher-than-population-average risk for breast cancer may benefit from starting screening earlier than presently recommended by the guidelines. The Personalized Risk Stratification for Prevention and Early Detection of Breast Cancer (PERSPECTIVE) approach aims to improve the prevention of breast cancer through differential screening recommendations based on a personal risk estimate. In our study, we used deliberative stakeholder consultations to engage health professionals in an in-depth dialog to explore the feasibility of the proposed implementation strategies for this new personalized breast cancer screening approach. Methods Deliberative stakeholder consultation is a qualitative descriptive study design used to engage health professionals in the discussion, while the mediators play a more passive role. A purposeful sample of 11 health professionals (family physicians and genetic counselors) working in Montreal was used. The deliberations were organized in two phases, including small group deliberations according to the deliberants’ health profession and a mixed group deliberation combining participants from the small groups. Inductive thematic content analysis was performed on the transcripts by two coders to create the deliberative and analytic outputs. Quality of deliberations was assessed quantitatively using the de Vries method and qualitatively using participant observation. Results One of our key findings was that health professionals lacked understanding of the two steps of the screening approach: risk stratification “screening,” which is an evaluation for the level of risk and screening for disease. As part of this confusion, the main topic of concern was a justification of program implementation as a population-wide screening, based on their uncertainty that it will be beneficial for women with near-population risks. Despite the noted difficulties concerning implementation, health professionals acknowledged the substantial benefits of the proposed PERSPECTIVE program. Conclusions Our study was the first to evaluate the perspectives of health professionals on the implementation and benefits of a new program for breast cancer risk stratification with the purpose of personalizing screening for disease. This new multi-step approach to screening requires more clarity in communication with health professionals. To implement and maintain effective screening, engagement of family physicians with other health professionals or even development of a centralized public health system may be needed.http://link.springer.com/article/10.1186/s40985-019-0111-5Breast cancer screeningDeliberative stakeholder consultationsRisk stratificationPersonalized screeningProgram implementation |
| spellingShingle | Svetlana Puzhko Justin Gagnon Jacques Simard Bartha Maria Knoppers Sophia Siedlikowski Gillian Bartlett Health professionals’ perspectives on breast cancer risk stratification: understanding evaluation of risk versus screening for disease Public Health Reviews Breast cancer screening Deliberative stakeholder consultations Risk stratification Personalized screening Program implementation |
| title | Health professionals’ perspectives on breast cancer risk stratification: understanding evaluation of risk versus screening for disease |
| title_full | Health professionals’ perspectives on breast cancer risk stratification: understanding evaluation of risk versus screening for disease |
| title_fullStr | Health professionals’ perspectives on breast cancer risk stratification: understanding evaluation of risk versus screening for disease |
| title_full_unstemmed | Health professionals’ perspectives on breast cancer risk stratification: understanding evaluation of risk versus screening for disease |
| title_short | Health professionals’ perspectives on breast cancer risk stratification: understanding evaluation of risk versus screening for disease |
| title_sort | health professionals perspectives on breast cancer risk stratification understanding evaluation of risk versus screening for disease |
| topic | Breast cancer screening Deliberative stakeholder consultations Risk stratification Personalized screening Program implementation |
| url | http://link.springer.com/article/10.1186/s40985-019-0111-5 |
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