Content of Official Written Information for Women on Breast Cancer Screening in Spain

Abstract

OBJECTIVE: There are several methods to promote informed decision making before undergoing a screening program. This research aimed to analyze the contents of official documents about breast cancer screening programs.

METHODS: A descriptive research was performed. After a literature review an agreed checklist was performed with the information needed to make decisions about participation in mammography screening programs. Informative documents about mammography screening valid in Spain in 2016 were analyzed by two independent researchers. The inter-rater agreement was verified and the discrepancies were solved by consensus. Absolute and relative frequencies of each item were calculated.

RESULTS: 8 invitations and 14 citation letters, 12 leaflets, 8 brochures and 14 websites, from 18 screening programs, were reviewed. The information turned out to be very different according to each program. Only a third warned that participation is voluntary. 8 programs (44.4%) offered information on what is breast cancer and 7 (38.9%) on the cumulative risk of developing the disease. 15 (83.3%) explained the objectives of the program and 14 (77.8%) explained what mammography is. 14 programs (77.8%) presented as screening benefits the least invasive treatments, 12 the increase in survival (66.7%) and 10 the decrease in specific mortality (55.6%). Most of the programs did not report the possibility of false positives (27.8%) or false negatives (38.9%). Only 7 (38.9%) mentioned the possibility of overdiagnosis and 6 (33.3%) of overtreatment.

CONCLUSIONS: The information provided by the different breast cancer screening programs is variable and does not contain sufficient information for informed decision-making.

OBJETIVO: Existen diversos metodos para facilitar la toma de decisiones informada antes de acudir a un programa de cribado. El objetivo de este trabajo fue analizar la informacion de los documentos oficiales sobre los programas de cribado de cancer de mama (PCCM).METODOS: Estudio descriptivo. Analisis del contenido de los documentos informativos de los PCCM vigentes en Espana en 2016. Se elaboro una lista de comprobacion con la informacion necesaria para la toma de decisiones. Dos investigadores revisaron independientemente los documentos. Se comprobo la concordancia interinvestigador y se resolvieron por consenso las discrepancias. Se calcularon las frecuencias absolutas y relativas de cada item.RESULTADOS: Se revisaron 8 cartas de invitacion a participar y 14 de citacion, 12 dipticos o tripticos, 8 folletos y 14 webs, procedentes de 18 PCCM. La informacion resulto ser muy dispar segun cada programa. 8 programas (44,4%) informaban sobre que es el cancer de mama y 7 (38,9%) sobre el riesgo acumulado de desarrollarlo. 15 (83,3%) explicaban los objetivos del PCCM y 14 (77,8%) en que consiste una mamografia. 14 programas (77,8%) presentaban como beneficios el cribado los tratamientos menos invasivos, 12 el aumento de la supervivencia (66,7%) y 10 la disminucion de la mortalidad especifica (55,6%). La mayoria de los programas no informaban sobre la posibilidad de falsos positivos (27,8%) o falsos negativos (38,9%). Solo 7 (38,9%) mencionaban la posibilidad de sobrediagnostico y 6 (33,3%) de sobretratamiento.CONCLUSIONES: La informacion que facilitan los diferentes PCCM es variable y no contiene informacion suficiente para la toma de decisiones informada.