scholarly journals Evaluation issues in the Swedish Two-County Trial of breast cancer screening: An historical review

2016 ◽  
Vol 24 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Laszlo Tabar ◽  
Tony Hsiu-Hsi Chen ◽  
Chen-Yang Hsu ◽  
Wendy Yi-Ying Wu ◽  
Amy Ming-Fang Yen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Controlled Trial ◽  
Historical Review ◽  
Breast Cancer Diagnosis ◽  
Mammographic Screening ◽  
Control Group ◽  
Full Account ◽  
Research Issues

Objectives To summarize debate and research in the Swedish Two-County Trial of mammographic screening on key issues of trial design, endpoint evaluation, and overdiagnosis, and from these to infer promising directions for the future. Methods A cluster-randomized controlled trial of the offer of breast cancer screening in Sweden, with a single screen of the control group at the end of the screening phase forms the setting for a historical review of investigations and debate on issues of design, analysis, and interpretation of results of the trial. Results There has been considerable commentary on the closure screen of the control group, ascertainment of cause of death, and cluster randomization. The issues raised were researched in detail and the main questions answered in publications between 1989 and 2003. Overdiagnosis issues still remain, but methods of estimation taking full account of lead time and of non-screening influences on incidence (taking place mainly before 2005) suggest that it is a minor phenomenon. Conclusion Despite resolution of issues relating to this trial in peer-reviewed publications dating from years, or even decades ago, issues that already have been addressed continue to be raised. We suggest that it would be more profitable to concentrate efforts on current research issues in breast cancer diagnosis, treatment, and prevention.

scholarly journals Effectiveness of An Educational Intervention of Breast Cancer Screening Practices Uptake, Knowledge, and Beliefs among Yemeni Female School Teachers in Klang Valley, Malaysia: A Study Protocol for a Cluster-Randomized Controlled Trial

2020 ◽  
Vol 17 (4) ◽  
pp. 1167
Author(s):  
Noman ◽  
Shahar ◽  
Abdul Rahman ◽  
Ismail
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Educational Intervention ◽  
Controlled Trial ◽  
Control Group ◽  
School Teachers ◽  
Randomized Controlled ◽  
Klang Valley ◽  
Cluster Randomized

Breast cancer is the most common cancer spread among women worldwide. Whereas many studies have discussed the significance of breast cancer screening among women in various countries, few have attempted to discuss this topic among female school teachers. As teachers educate and communicate with students, this may play an essential role in health education and in promoting healthy behavior, such as breast cancer screening. The primary goal of this study is to develop and implement an educational intervention of breast cancer screening and evaluate its effectiveness among Yemeni female school teachers in Malaysia. This was carried out as per the health belief model. A cluster-randomized controlled trial was conducted among 183 Yemeni female school teachers in twelve schools in Klang Valley, Malaysia. A random assignment of the target schools was made to include them within the intervention or control group. Participants in the intervention group were offered a 90-minute session for one-day educational intervention on breast cancer screening. On the other hand, participants in the control group were offered the same educational materials at the end of the study. Relevant data was collected at baseline, one month following the intervention, and then three- and six-months follow-up assessments. Analysis of such data was done via IBM SPSS software 25.0 by generalized estimating equations (GEE) to assess the differential changes over time. A primary outcome embodied in breast cancer screening practice uptake was expected. Secondary outcomes include the target group's knowledge on and beliefs of breast cancer screening. This study intends to contribute to the credibility and effectiveness of utilizing a theory-based breast cancer screening intervention in order to raise the awareness of women on conducting breast cancer screening.

scholarly journals Breast cancer screening patterns in Jamaican women: review of the largest national mammography clinic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sheray N. Chin ◽  
Derria Cornwall ◽  
Derek I. Mitchell ◽  
Michael E. McFarlane ◽  
Joseph M. Plummer
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Cancer Diagnosis ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Screening Guidelines ◽  
National Breast ◽  
Jamaican Women ◽  
The Impact

Abstract Background Breast cancer is the leading cause of cancer and cancer related deaths in Jamaican women. In Jamaica, women often present with advanced stages of breast cancer, despite the availability of screening mammography for early detection. The utilization of screening mammography for early breast cancer diagnosis seems to be limited, and this study investigated the national patterns of mammographic screening and the impact of mammography on the diagnosis of breast cancer in Jamaica. Methods A retrospective analysis of the records of the largest mammography clinic in Jamaica was done for the period January 2011 to December 2016. Descriptive statistics was performed on relevant patient characteristics with calculation of rates and proportions; cross-tabulations were utilized to assess relationship of covariates being studied on the outcomes of interest. Results are reported in aggregate form with no identifiable patient data. Results 48,203 mammograms were performed during the study period. 574 women (1.2%) had mammograms suspicious for breast cancer with median age of 57 years (range 30–95 years); 35% were under the age of 50. 4 women with suspicious findings had undergone ‘screening mammography’, with the remaining having ‘diagnostic mammography’. 38% reported previous mammograms, with a mean interval of 8 years between previous normal mammogram and mammogram suspicious for breast cancer. Median age at first screening mammogram was 51 years (range 41–77). Conclusion Breast cancer screening mammography is underutilized in Jamaica. An organized national breast cancer screening programme is recommended to improve adherence to international breast cancer screening guidelines.

scholarly journals Effect of an information leaflet on breast cancer screening participation: A cluster randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jose Maria Montero-Moraga ◽  
Margarita Posso ◽  
Marta Román ◽  
Andrea Burón ◽  
Maria Sala ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Information Leaflet ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Objective To evaluate the impact of an information leaflet about the risk-benefit balance of breast cancer screening on women’s participation. Methods This cluster randomized controlled trial was conducted within a population-based breast cancer screening program and included women from the catchment areas of two hospitals in Barcelona, Spain. We evaluated women aged 50–69 years invited to screening between September 2019 and January 2020. The intervention group received an information leaflet on the benefits and harms of mammography screening. The control group received the usual invitation letter. The clusters consisted of the processing days of the invitation letter, assigned to the intervention with a simple random allocation scheme. We compared the participation rate at the individual level between groups, stratified by hospital and by per-protocol and intention-to-treat analyses. Results We included 11,119 women (137 clusters): 5416 in the intervention group (66 clusters) and 5703 in the control group (71 clusters). A total of 36% (1964/5393) of the women in the intervention group and 37% (2135/5694) of those in the control group attended screening, respectively. Overall, we found no differences in participation among groups (difference in participation − 1.1%; 95%CI; − 2.9 to 0.7%). In a hospital attending a population with a low socioeconomic status, attendance was lower in the intervention group (− 1.4, 95%CI: − 5.7% to − 0.03%). Conclusions Overall participation in our program was unaffected by a new information leaflet on the risk-benefit balance of breast cancer screening. However, participation was lower in certain populations with lower socioeconomic status Trial registration Trial registration number ISRCTN13848929.

The Impact of the Theory-Based Training on Beliefs of Women towards Breast Cancer Screening Behaviors

2020 ◽  
Vol 16 (3) ◽  
pp. 229-235
Author(s):  
Alireza Didarloo ◽  
Leila Mokhtary ◽  
Hamid-Reza Khalkhali ◽  
Soheila Ahangarzadeh-Rezaei
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Health Beliefs ◽  
Educational Intervention ◽  
Intervention Group ◽  
Health Belief ◽  
Control Group ◽  
Belief Model ◽  
Screening Behaviors

Background: Breast cancer is the most prevalent type of cancer among women that is fatal if not diagnosed and treated in due time. Health beliefs play an important role in people's willingness to engage in health-promoting behaviors. Objective: The aim of the study was to examine the effects of the health belief model (HBM)-based training intervention on women’s health beliefs towards breast cancer screening behaviors. Methods: The study of educational intervention was conducted on women referred to healthcare centers. The sample was selected by convenient sampling and randomly assigned to control and intervention groups of 50 subjects. The intervention group received the theory-based training intervention, but the control group received only the routine care. Champion’s Health Belief Model Scale (CHBMS) was used for collecting the study data. Data analysis was performed using independent t-test, paired t-test, Chi-squared test, and correlation coefficient in SPSS software version 16.00. Results: The mean age of the subjects for control and intervention groups was 39.06±9.78, 38.32±8.27, respectively. Overall, 38%, 12% and 13%of the subjects reported breast selfexamination behavior, mammography and clinical breast examinations, respectively. Before the intervention program, the overall mean score of health beliefs in groups of control and intervention was 160.82±23.28, and 159.14±20.61, respectively. After educational intervention, the overall mean score of beliefs in the intervention group changed from 159.14±20.61 to 195.26±24.42, and it was statistically significant (p<0.001). In the control group, after the intervention, no significant changes were observed in the mean score of total health beliefs and were not statistically significant (p>0.05). Among the variables of the HBM, women's perceived self-efficacy toward breast selfexamination experienced the most positive change after an educational intervention. Conclusion: Our results indicated that HBM-based training significantly improved women’s beliefs toward breast cancer screening behaviors. It is suggested that trainers in the healthcare system use these educational approaches to promote people’s beliefs toward breast cancer and its screening methods.

scholarly journals Lower attendance rates in immigrant versus non-immigrant women in the Norwegian Breast Cancer Screening Programme

2017 ◽  
Vol 25 (3) ◽  
pp. 155-161 ◽  
Author(s):  
Sameer Bhargava ◽  
Kaitlyn Tsuruda ◽  
Kåre Moen ◽  
Ida Bukholm ◽  
Solveig Hofvind
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Programme ◽  
Immigrant Women ◽  
Population Based ◽  
Mammographic Screening ◽  
Attendance Rates ◽  
Breast Cancer Screening Programme ◽  
Cancer Screening Programme

Objective The Norwegian Breast Cancer Screening Programme invites women aged 50–69 to biennial mammographic screening. Although 84% of invited women have attended at least once, attendance rates vary across the country. We investigated attendance rates among various immigrant groups compared with non-immigrants in the programme. Methods There were 4,053,691 invitations sent to 885,979 women between 1996 and 2015. Using individual level population-based data from the Cancer Registry and Statistics Norway, we examined percent attendance and calculated incidence rate ratios, comparing immigrants with non-immigrants, using Poisson regression, following women's first invitation to the programme and for ever having attended. Results Immigrant women had lower attendance rates than the rest of the population, both following the first invitation (53.1% versus 76.1%) and for ever having attended (66.9% versus 86.4%). Differences in attendance rates between non-immigrant and immigrant women were less pronounced, but still present, when adjusted for sociodemographic factors. We also identified differences in attendance between immigrant groups. Attendance increased with duration of residency in Norway. A subgroup analysis of migrants' daughters showed that 70.0% attended following the first invitation, while 82.3% had ever attended. Conclusions Immigrant women had lower breast cancer screening attendance rates. The rationale for immigrant women's non-attendance needs to be explored through further studies targeting women from various birth countries and regions.

Effect of an Information Leaflet on Breast Cancer Screening Participation. A Randomized Controlled Study

2021 ◽  
Author(s):  
Jose Maria Montero-Moraga ◽  
Margarita Posso ◽  
Marta Román ◽  
Andrea Burón ◽  
Maria Sala ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Socioeconomic Status ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Intervention Group ◽  
Controlled Study ◽  
Control Group ◽  
P Value ◽  
Information Leaflet ◽  
Lower Socioeconomic

Abstract Objective: To evaluate the impact of an information leaflet about the risk-benefit balance of breast cancer screening on women’s participation.Methods: This randomized controlled study was conducted within a population-based breast cancer screening program and included women from the catchment areas of two hospitals in Barcelona, Spain. We evaluated women aged 50-69 years invited to screening between September 2019 and January 2020. One hospital attended a population with a lower socioeconomic status than the other. The intervention group received an information leaflet on the benefits and harms of mammography screening. The control group received the usual invitation letter. We compared the participation rate between groups, stratified by hospital and by per-protocol and intention-to-treat analyses. Results: We included 11,119 women in the study: 5,416 in the intervention group and 5,703 in the control group. A total of 36.4% (1,964/5,393) of the women in the intervention group and 37.5% (2,135/5,694) of those in the control group attended screening, respectively. Overall, we found no differences in participation among groups (difference in participation -1.1%; 95% CI; -2.9% to 0.7%, p-value=0.240). In the hospital attending a population with a low socioeconomic status, attendance was lower in the intervention group (-1.4%, 95% CI: -5.7% to -0.03%, p-value=0.029). In the per-protocol analysis, participation was lower in the intervention group (-2.6%, 95% CI: -4.6% to -0.5%, p-value=0.015). Conclusions: Overall participation in our program was unaffected by a new information leaflet on the risk-benefit balance of breast cancer screening. However, participation was lower in certain populations with lower socioeconomic status.

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