title: Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group.
abstract: Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p < 0.0001) and medium household income (RR = 1.05; [95%IC: 1.01-1.09]; p = 0.0074) were independently associated with attendance for screening. This large-scale study demonstrates that the decision aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated.
authors.affiliation: Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France.|EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France.
authors.forename: Aurelie
authors.initials: A
authors.lastname: Bourmaud
authors.affiliation: Adémas-69, Association pour le Dépistage Organisé des Cancers dans le Rhône, Lyon, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Soler-Michel
authors.affiliation: Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France.|Jean Monnet University, Saint-Etienne, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Oriol
authors.affiliation: Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Regnier
authors.affiliation: Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Tinquaut
authors.affiliation: Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Nourissat
authors.affiliation: Jean Monnet University, Saint-Etienne, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Bremond
authors.affiliation: Lyon 1 University, Lyon, France.|GATE-LSE UMR 5824 CNRS, Lyon, France.|Léon Bérard Cancer Centre, Lyon, France.
authors.forename: Nora
authors.initials: N
authors.lastname: Moumjid
authors.affiliation: Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France.|EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France.|Jean Monnet University, Saint-Etienne, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Chauvin
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control*; D003661:Decision Support Techniques; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged
keywords: breast cancer screening; decision aid; decision making patient education; informed decision; randomized control trial