British journal of cancer · 2026
Priorities for breast cancer risk assessment in UK women under age 50: a survey and discrete choice experiment.
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Dennison Rebecca A, Valasaki Maria, Wright Stuart, Frost Reuben, Howell Sacha J, Antoniou Antonis C, Easton Douglas F, Morris Stephen, Garcia-Closas Montserrat, Woof Victoria G, French David P, Usher-Smith Juliet A
Аннотация
BACKGROUND: National guidelines recommend English women between 30 and 49 years with moderate/high risk of breast cancer (BC) be offered screening and prevention interventions. Identification largely relies on family history-based criteria amongst women self-presenting in primary care. We aimed to understand the preference for different potential risk assessment strategies in this population.
METHODS: A cross-sectional survey including a discrete choice experiment. Risk assessments were defined using six attributes, including initiation strategy, eligibility for a full/detailed risk assessment, components of the risk assessment, including multifactorial risk assessment based on the BOADICEA/CanRisk model, and sensitivity. Coefficients from conditional logistic regression were used to estimate preference for different risk assessment approaches compared to current care.
RESULTS: Participants (n = 893) preferred alternative approaches for risk assessments over current care, particularly where all eligible women were proactively invited and more above-average risk women were correctly identified. All but one of 21 risk assessment approaches was preferred, with the most favoured approaches having a probability of being preferred over current care >92%. Education level and ethnicity potentially impacted the strength of participant priorities.
CONCLUSIONS: Offering multifactorial BC risk assessments to younger women in primary care, especially the most proactive and broad approaches, would be acceptable and preferred over current practice.
METHODS: A cross-sectional survey including a discrete choice experiment. Risk assessments were defined using six attributes, including initiation strategy, eligibility for a full/detailed risk assessment, components of the risk assessment, including multifactorial risk assessment based on the BOADICEA/CanRisk model, and sensitivity. Coefficients from conditional logistic regression were used to estimate preference for different risk assessment approaches compared to current care.
RESULTS: Participants (n = 893) preferred alternative approaches for risk assessments over current care, particularly where all eligible women were proactively invited and more above-average risk women were correctly identified. All but one of 21 risk assessment approaches was preferred, with the most favoured approaches having a probability of being preferred over current care >92%. Education level and ethnicity potentially impacted the strength of participant priorities.
CONCLUSIONS: Offering multifactorial BC risk assessments to younger women in primary care, especially the most proactive and broad approaches, would be acceptable and preferred over current practice.