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Risk-stratified breast cancer screening is feasible, with low-risk women accepting reduced screening. Automated risk communication shows minimal short-term psychological impact, but final results are pending.

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Area of Science:

  • Oncology
  • Preventive Medicine
  • Medical Imaging

Background:

  • Risk-stratified screening for breast cancer aims to optimize the benefit-to-harm ratio.
  • The psychological effects of communicating risk and the acceptance of reduced screening by low-risk women remain under-explored.

Purpose of the Study:

  • To assess the feasibility and psychological impact of risk-stratified breast cancer screening.
  • To evaluate the acceptance of de-escalated screening among women identified as low-risk.

Main Methods:

  • A randomized clinical trial involving 1,801 women aged 50-67 undergoing routine mammography.
  • The intervention group received 10-year breast cancer risk assessments using the CanRisk model and automated risk communication.
  • Risk categories (low, intermediate, elevated, high) determined personalized screening intervals.

Main Results:

  • Of the intervention group, 49.6% were classified as low-risk.
  • 3.8% of low-risk women rejected de-escalated screening (4-year interval).
  • No significant adverse psychological effects were observed; quality of life slightly decreased in controls, while breast cancer worry reduced in low/intermediate risk groups.

Conclusions:

  • Risk-stratified breast cancer screening is feasible and acceptable for low-risk individuals.
  • Automated risk communication appears to have a minimal short-term impact on psychological well-being.
  • Long-term outcomes require further evaluation at 800 days.