title: Breast cancer risk feedback to women in the UK NHS breast screening population.
abstract: There are widespread moves to develop risk-stratified approaches to population-based breast screening. The public needs to favour receiving breast cancer risk information, which ideally should produce no detrimental effects. This study investigates risk perception, the proportion wishing to know their 10-year risk and whether subsequent screening attendance is affected.
  
  
  
  Fifty thousand women attending the NHS Breast Screening Programme completed a risk assessment questionnaire. Ten-year breast cancer risks were estimated using a validated algorithm (Tyrer-Cuzick) adjusted for visually assessed mammographic density. Women at high risk (⩾8%) and low risk (<1%) were invited for face-to-face or telephone risk feedback and counselling.
  
  
  
  Of those invited to receive risk feedback, more high-risk women, 500 out of 673 (74.3%), opted to receive a consultation than low-risk women, 106 out of 193 (54.9%) (P<0.001). Women at high risk were significantly more likely to perceive their risk as high (P<0.001) and to attend their subsequent mammogram (94.4%) compared with low-risk women (84.2%; P=0.04) and all attendees (84.3%; ⩽0.0001).
  
  
  
  Population-based assessment of breast cancer risk is feasible. The majority of women wished to receive risk information. Perception of general population breast cancer risk is poor. There were no apparent adverse effects on screening attendance for high-risk women whose subsequent screening attendance was increased.
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.|Genomic Medicine, Manchester Academic Health Sciences Centre, University of Manchester and Central Manchester Foundation Trust, Manchester M13 9WL, UK.|The Christie NHS Foundation Trust, Withington, Manchester M20 4BX, UK.
authors.forename: D Gareth R
authors.initials: DG
authors.lastname: Evans
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Louise S
authors.initials: LS
authors.lastname: Donnelly
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.|Centre for Imaging Sciences, Institute for Population Health, University of Manchester, Oxford Road, Manchester M13 9PT, UK.|The University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Elaine F
authors.initials: EF
authors.lastname: Harkness
authors.affiliation: Centre for Imaging Sciences, Institute for Population Health, University of Manchester, Oxford Road, Manchester M13 9PT, UK.|The University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Astley
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.|The University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Paula
authors.initials: P
authors.lastname: Stavrinos
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dawe
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Donna
authors.initials: D
authors.lastname: Watterson
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Lynne
authors.initials: L
authors.lastname: Fox
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester M13 9PT, UK.|NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, UK.
authors.forename: Jamie C
authors.initials: JC
authors.lastname: Sergeant
authors.affiliation: Centre for Health Informatics, Institute of Population Health, University of Manchester, Vaughan House, Portsmouth Street, Manchester M13 9GB, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ingham
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Harvie
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Wilson
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
authors.forename: Ursula
authors.initials: U
authors.lastname: Beetles
authors.affiliation: Centre for Health Informatics, Institute of Population Health, University of Manchester, Vaughan House, Portsmouth Street, Manchester M13 9GB, UK.
authors.forename: Iain
authors.initials: I
authors.lastname: Buchan
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.
authors.forename: Adam R
authors.initials: AR
authors.lastname: Brentnall
authors.affiliation: School of Psychological Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
authors.forename: David P
authors.initials: DP
authors.lastname: French
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.
authors.forename: Jack
authors.initials: J
authors.lastname: Cuzick
authors.affiliation: Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.|The Christie NHS Foundation Trust, Withington, Manchester M20 4BX, UK.|Centre for Imaging Sciences, Institute for Population Health, University of Manchester, Oxford Road, Manchester M13 9PT, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Howell
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D018570:Risk Assessment; D006113:United Kingdom