Women's Views on Overdiagnosis in Breast Cancer Screening
Women's Views on Overdiagnosis in Breast Cancer Screening
Overdiagnosis was unfamiliar to a diverse sample of women eligible for mammography screening in Australia. None the less, we found it was possible to explain the issue in such a way that most participants understood the concept and its implications. Women’s screening preferences were sensitive to the estimated level of overdiagnosis, underscoring the need for urgent efforts to clarify this issue. Critically, women differed in the way they evaluated the relevance of overdiagnosis in making their personal decisions about screening. Some felt that the new information was unlikely to change their existing attitudes and intentions; others considered it important to take the risk of overdiagnosis into account, particularly at higher estimates. Many women expressed a preference for this information to be more widely available. However, their responses to being informed about overdiagnosis also revealed a range of potentially unwanted consequences that communicators must address. Finally, the diversity of views elicited in this study highlights the inappropriateness of making screening policy and communication decisions based on speculative assumptions about what women want and think regarding overdiagnosis. Instead, it is vital that research efforts continue to better understand women’s values about overdiagnosis, to clarify its influence on their behaviour, and to determine the optimal methods to support informed choice in mammography screening.
Conclusions
Overdiagnosis was unfamiliar to a diverse sample of women eligible for mammography screening in Australia. None the less, we found it was possible to explain the issue in such a way that most participants understood the concept and its implications. Women’s screening preferences were sensitive to the estimated level of overdiagnosis, underscoring the need for urgent efforts to clarify this issue. Critically, women differed in the way they evaluated the relevance of overdiagnosis in making their personal decisions about screening. Some felt that the new information was unlikely to change their existing attitudes and intentions; others considered it important to take the risk of overdiagnosis into account, particularly at higher estimates. Many women expressed a preference for this information to be more widely available. However, their responses to being informed about overdiagnosis also revealed a range of potentially unwanted consequences that communicators must address. Finally, the diversity of views elicited in this study highlights the inappropriateness of making screening policy and communication decisions based on speculative assumptions about what women want and think regarding overdiagnosis. Instead, it is vital that research efforts continue to better understand women’s values about overdiagnosis, to clarify its influence on their behaviour, and to determine the optimal methods to support informed choice in mammography screening.
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