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Eur J Cancer Care (Engl). 2017 May;26(3). doi: 10.1111/ecc.12660. Epub 2017 Feb 1.

A qualitative study on a decision aid for breast cancer screening: Views from women and health professionals.

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Canary Islands Foundation of Health Research (FUNCANIS), Tenerife, Spain.
Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain.
Basic Medical Sciences Department, University of Lleida-IRBLLEIDA, Lleida, Spain.
Research Group in Economic Analysis and Health (GRAES, 2014 SGR 978), Rovira i Virgili University (URV), Reus, Spain.
ÀreaQ, Evaluation and Qualitative Research, Barcelona, Spain.
Escola Universitària d'Infermeria i Teràpia Ocupacional (EUIT), Terrassa, Universitat Autónoma de Barcelona, Barcelona, Spain.
Department of Economics and CREIP, Rovira i Virgili University (URV), Tarragona, Spain.
Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain.
Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.
Department of Nursing, Faculty of Medicine, Universitat Autónoma de Barcelona, Bellaterra, Spain.
Researcher in Grups de Recerca d'America i Àfrica Llatines (GRAAL) (2014 SGR 1175), Barcelona, Spain.
Researcher Collaborator of the Infectious Diseases Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.


This qualitative study evaluates a decision aid that includes the benefits and harms of breast cancer screening and analyses women's perception of the information received and healthcare professionals' perceptions of the convenience of providing it. Seven focus groups of women aged 40-69 years (n = 39) and two groups of healthcare professionals (n = 23) were conducted in Catalonia and the Canary Islands. The focus groups consisted of guided discussions regarding decision-making about breast cancer screening, and acceptability and feasibility of the decision aid. A content analysis was performed. Women positively value receiving information regarding the benefits and harms of breast cancer screening. Several women had difficulties understanding some concepts, especially those regarding overdiagnosis. Women preferred to share the decisions on screening with healthcare professionals. The professionals noted the lack of inclusion of some harms and benefits in the decision aid, and proposed improving the clarity of the statistical information. The information on overdiagnosis generates confusion among women and controversy among professionals. Faced with the new information presented by the decision aid, the majority of women prefer shared decision-making; however, its feasibility might be limited by a lack of knowledge and attitudes of rejection from healthcare professionals.


breast cancer screening; decision aid; decision-making; patients’ information

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