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 métodos para facilitar la toma de decisiones informada antes de acudir a un programa de cribado. El objetivo de este trabajo fue analizar la información de los documentos oficiales sobre los programas de cribado de cáncer de mama (PCCM).
Metodos: Estudio descriptivo. Análisis del contenido de los documentos informativos de los PCCM vigentes en España en 2016. Se elaboró una lista de comprobación con la información necesaria para la toma de decisiones. Dos investigadores revisaron independientemente los documentos. Se comprobó la concordancia interinvestigador y se resolvieron por consenso las discrepancias. Se calcularon las frecuencias absolutas y relativas de cada ítem.
Resultados: Se revisaron 8 cartas de invitación a participar y 14 de citación, 12 dípticos o trípticos, 8 folletos y 14 webs, procedentes de 18 PCCM. La información resultó ser muy dispar según cada programa. 8 programas (44,4%) informaban sobre qué es el cáncer 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 qué consiste una mamografía. 14 programas (77,8%) presentaban como beneficios el cribado los tratamientos menos invasivos, 12 el aumento de la supervivencia (66,7%) y 10 la disminución de la mortalidad específica (55,6%). La mayoría de los programas no informaban sobre la posibilidad de falsos positivos (27,8%) o falsos negativos (38,9%). Sólo 7 (38,9%) mencionaban la posibilidad de sobrediagnóstico y 6 (33,3%) de sobretratamiento.
Conclusiones: La información que facilitan los diferentes PCCM es variable y no contiene información suficiente para la toma de decisiones informada.
Keywords: Breast neoplasm; Decision making; Health Communication; Health Literacy; Information services; Mammography; Secondary prevention; Spain; Straining; Use of scientific information for health decision making.