title: A promoting early presentation intervention increases breast cancer awareness in older women after 2 years: a randomised controlled trial.
abstract: BACKGROUND
  We have developed the Promoting Early Presentation (PEP) Intervention to equip older women with the knowledge, skills, confidence and motivation to present promptly with breast symptoms, and thereby improve survival from breast cancer. The PEP Intervention consists of a 10-min interaction between a radiographer and an older woman, supported by a booklet. Our previous report showed that at 1 year, the PEP intervention increased the proportion who were breast cancer aware compared with usual care.
  
  
  METHODS
  We randomised 867 women aged 67-70 years attending for their final routine appointment on the National Health Service Breast Screening Programme to receive the PEP Intervention, a booklet alone or usual care. The primary outcome was breast cancer awareness measured using a validated questionnaire asking about knowledge of breast cancer symptoms, knowledge that the risk of breast cancer increases with age and breast checking behaviour.
  
  
  RESULTS
  At 2 years, the PEP Intervention increased the proportion who were breast cancer aware compared with usual care (21 vs 6%; odds ratio 8.1, 95% confidence interval 2.7-25.0).
  
  
  CONCLUSIONS
  The uniquely large and sustained effect of the PEP Intervention on breast cancer awareness increases the likelihood that a woman will present promptly should she develop breast cancer symptoms up to many years later.
authors.affiliation: Promoting Early Presentation Group, Kings College London, Adamson Centre for Mental Health, South Wing, St Thomas' Hospital, London SE1 7EH, UK. lindsay.forbes@kcl.ac.uk
authors.forename: L J L
authors.initials: LJ
authors.lastname: Forbes
authors.forename: L
authors.initials: L
authors.lastname: Linsell
authors.forename: L
authors.initials: L
authors.lastname: Atkins
authors.forename: C
authors.initials: C
authors.lastname: Burgess
authors.forename: L
authors.initials: L
authors.lastname: Tucker
authors.forename: L
authors.initials: L
authors.lastname: Omar
authors.forename: A J
authors.initials: AJ
authors.lastname: Ramirez
mesh_terms: D000368:Aged; D001364:Awareness; D001943:Breast Neoplasms / Q000175:diagnosis*; D042241:Early Diagnosis; D018479:Early Intervention, Educational; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans