"It Will Lead You to Make Better Decisions about Your Health"-A Focus Group and Survey Study on Women's Attitudes towards Risk-Based Breast Cancer Screening and Personalised Risk Assessments

Curr Oncol. 2022 Nov 25;29(12):9181-9198. doi: 10.3390/curroncol29120719.

Abstract

Singapore launched a population-based organised mammography screening (MAM) programme in 2002. However, uptake is low. A better understanding of breast cancer (BC) risk factors has generated interest in shifting from a one-size-fits-all to a risk-based screening approach. However, public acceptability of the change is lacking. Focus group discussions (FGD) were conducted with 54 women (median age 37.5 years) with no BC history. Eight online sessions were transcribed, coded, and thematically analysed. Additionally, we surveyed 993 participants in a risk-based MAM study on how they felt in anticipation of receiving their risk profiles. Attitudes towards MAM (e.g., fear, low perceived risk) have remained unchanged for ~25 years. However, FGD participants reported that they would be more likely to attend routine mammography after having their BC risks assessed, despite uncertainty and concerns about risk-based screening. This insight was reinforced by the survey participants reporting more positive than negative feelings before receiving their risk reports. There is enthusiasm in knowing personal disease risk but concerns about the level of support for individuals learning they are at higher risk for breast cancer. Our results support the empowering of Singaporean women with personal health information to improve MAM uptake.

Keywords: breast cancer; focus group discussion; genetic literacy; health behaviour; health consciousness; mammography screening; precision health; qualitative research; risk-based screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breast Neoplasms* / diagnosis
  • Breast Neoplasms* / prevention & control
  • Early Detection of Cancer / methods
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Risk Assessment

Grants and funding

This study is supported by the Agency for Science, Technology and Research (A*STAR) under its Social Sciences Innovation Seed Fund (C211618001). BREATHE is funded by the JurongHealth Fund (reference number JHF-20-RE-003) and the PRECISION Health Research, Singapore Clinical Implementation Pilot (PRECISE CIP) Fund. MH is supported by the JurongHealth Fund, PRECISION Health Research, Singapore Clinical Implementation Pilot (PRECISE CIP) Fund, the Breast Cancer Prevention Programme under Saw Swee Hock School of Public Health Programme of Research Seed Funding (SSHSPH-Res-Prog-BCPP), Breast Cancer Screening Prevention Programme under Yong Loo Lin School of Medicine (NUHSRO/2020/121/BCSPP/LOA), National Medical Research Council Clinician Scientist Award (Senior Investigator Category, NMRC/CSA-SI/0015/2017), the National University Cancer Institute Singapore (NCIS) Centre Grant Programme (CGAug16M005), NCIS Ng Teng Fong General Hospital Collaborative grant (CGAug16C002) and Asian Breast Cancer Research Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.