Do women make an informed choice about participating in breast cancer screening? A survey among women invited for a first mammography screening examination

Objective: To determine the level of informed choice in women invited for breast cancer screening for the first time. Methods: To determine the content of decision-relevant knowledge, 16 experts were asked to judge whether each of 51 topics represented essential information to enable informed choices. To assess the level of informed choices, a questionnaire was then sent to all 460 invited women in the south-western part of the Netherlands who turned 50 in August 2008. Results: Of all 229 respondents, 95% were deemed to have sufficient knowledge as they answered at least 8 out of 13 items correctly. In 90% there was consistency between intention (not) to participate and attitude. As a result, 88% made an informed choice. Sixty-eight percent of women responded correctly on the item of over-diagnosis. Even if all non-respondents were assumed to have no knowledge, 50% of the total group invited to participate still had sufficient knowledge. Conclusions: Women were deemed to have sufficient relevant knowledge of the benefits and harms if they answered at least half of the items correctly. Practice implications: To further increase informed choices in breast cancer screening, information on some of the possible harms merits further attention.

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