Organisational characteristics of informed decision-making implementation in mammography screening programmes in 28 European countries
(2020) 12th European Breast Cancer Conference (EBCC-12) — Location: Virtual Conference (2.October.2020)
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- BACKGROUND: Although much research has been published on interventions designed to facilitate informed decision-making in mammography screening few comparable data is available regarding the approaches taken by screening programmes towards real-world implementation. Therefore, this study aimed to provide a comprehensive overview of the situation by exploring the characteristics of how mammography screening programmes in Europe address informed decision-making. MATERIAL AND METHODS: Data was collected via an online survey distributed to screening programme coordinators in Europe. Responses provided to the survey questions addressing the official policy of the programmes towards informed decision making, plus the strategy for implementation and evaluation were used to compute using a Multiple Correspondence Analysis to facilitate a Hierarchical Cluster Analysis of the mammography screening programmes into comparable groups. RESULTS: 35 responses were received representing independent mammography screening programmes from 28 different European countries. 27 respondents reported that the programme provides information to women on the benefits and harms of mammography screening and that a policy is in place for facilitating informed decision-making for women offered screening. Heterogeneity was reported towards the modalities used to implement the policy with 10 programmes stating that decision aids are used in practice to support informed choice. Only one programme reported an attempt to measure the proportion of women who have made an informed decision. The cluster analysis identified three emerging categories of programmes: established programmes distinguished by either reporting a policy specific to mammography screening and resources directed to implementation; established programmes with a general policy, applicable to other screening programmes, and the lack of administrative support to monitor implementation; and emerging programmes without a defined policy and few information provided to women regarding the benefits and harms of mammography screening. No statistically significant differences in participation rates amongst the two categories with a policy. CONCLUSIONS: The data indicates a broad adoption by mammography screening programmes in Europe of the principle of supporting informed decision-making defined by either a specific or general policy directive. Validated best practices of how to develop, implement and evaluate a specific policy to promote informed decision-making, with culturally appropriate and responsive tools for measurement of informed choice, would provide much needed support cancer screening programmes to ensure that they help women make an informed choice.
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Ritchie, D., Van Hal, G., & Van den Broucke, S. (2020). Organisational characteristics of informed decision-making implementation in mammography screening programmes in 28 European countries. European Journal of Cancer, 138(Suppl 1), S99. https://doi.org/10.1016/s0959-8049(20)30801-7 (Original work published 2020)