A scoping review of communication tools for risk-based breast cancer screening.

Abstract

Risk-based breast cancer screening involves giving women tailored recommendations regarding breast screening initiation, frequency and imaging modalities based on their personal breast cancer risk. It is unclear what risk-based screening communication tools exist across the world for women between 50 and 74 years of age. Hence this scoping review aimed to investigate the breadth of communication tools available to inform women, without a previous breast cancer diagnosis nor those who are known carriers of cancer-susceptibility genes, of risk-based screening and to report an overview of the information the tools present. Medline, CINAHL, Scopus and Cochrane Library databases and grey literature using Google advanced were searched. The readability, understandability and actionability of each tool was assessed. Four research articles and five additional communication tools were identified as relevant for the design and testing of risk-based screening communication. The discussed benefits and harms of risk-based screening and breast cancer risk factors varied between communication tools with some including outcomes not substantiated by robust evidence. Moreover, the readability and actionability of communication tools varied and were limited. The understandability of most tools was adequate. There are few risk-based screening communication tools designed, tested and available for women without a previous breast cancer diagnosis nor those who are known carriers of cancer-susceptibility genes. Addressing the balance of risks and benefits in future communication tools, and their readability and actionability is important for access to valuable decision support.