Factors Influencing Adherence to the Risk Management Program for Women With a Genetic Predisposition to Breast
Ke Zhou1, Martine Bellanger1,2, Louise Crivelli3
1Department of Human and Social Sciences, Institut de Cancérologie de l'Ouest (ICO), Saint-Herblain, France.
The Oncologist
|April 2, 2024
Summary
High genetic risk for breast cancer (BC) does not guarantee adherence to screening programs. Factors related to the screening rounds themselves, not patient risk, influence timely participation.
Area of Science:
- Oncology
- Genetics
- Public Health
Background:
- Genetic predispositions, such as BRCA1 and BRCA2 mutations, increase breast cancer (BC) risk.
- Risk management programs are effective if adhered to, but adherence in high-risk women can be inconsistent.
- Ensuring uniform adherence to BC screening protocols remains a challenge.
Purpose of the Study:
- To identify factors influencing adherence to breast cancer (BC) screening programs in women with genetic predispositions.
- To analyze determinants of timely versus postponed screening in a high-risk population.
Main Methods:
- Multicenter study analyzing data from a BC surveillance program across 4 French regions.
- Multilevel logistic modeling used to assess factors associated with on-time or postponed annual screenings.
- Data from 778 participants over a median of 4.7 years.
Main Results:
- Overall, 5.4% of 2796 annual screening rounds were postponed.
- Women with prevalent BC or BRCA1/BRCA2 mutations showed no better adherence than lower-risk women.
- Adherence improved after the second screening round; however, recalls were associated with worse adherence.
- Postponed screenings increased from 2015-2017 to 2018-2020.
Conclusions:
- Higher breast cancer risk status does not correlate with improved adherence to risk management programs.
- Screening round-related factors, not patient risk, were found to reduce postponements.
- Further research is needed on screening organizational factors to enhance adherence.
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