Influence of Nurses on Compliance with Breast Screening Recommendations in an Organized Breast Screening Program

Inference on cancer screening exam accuracy using population-level administrative data

This paper develops a model for cancer screening and cancer incidence data, accommodating the partially unobserved disease status, clustered data structures, general covariate effects, and dependence between exams. The true unobserved cancer and detection status of screening participants are treated as latent variables, and a Markov Chain Monte Carlo algorithm is used to estimate the Bayesian posterior distributions of the diagnostic error rates and disease prevalence. We show how the Bayesian approach can be used to draw inferences about screening exam properties and disease prevalence while allowing for the possibility of conditional dependence between two exams. The techniques are applied to the estimation of the diagnostic accuracy of mammography and clinical breast examination using data from the Ontario Breast Screening Program in Canada.

[Barriers in the breast cancer screening and the role of nursing: an integrative review]

Mammographic breast cancer screening is a fact in developed countries. Nursing acts in different ways in this process, having an important role in the barriers related to non-adherence to screening, but its effectiveness is little proven, with limited number of clinical trials about this topic. An integrative review of the literature in PubMed and LILACS (Latin American Literature) was conducted, aiming to evaluate controlled clinical trials about nurse's role in breast cancer screening. It was used the key words breast cancer screening, clinical trials and nurse. From 110 publications in PubMed, 18 were clinical trials and showed the nurse's role in breast cancer screening. None publication was observed in LILACS database. This review shows the effectiveness of nursing in breast cancer screening, presenting new nurse's role in the multidisciplinary team that qualify actions related to women's health.

Satisfaction with initial screen and compliance with biennial breast screening at centers with and without nurses

BACKGROUND

A woman's experience during her initial breast screen can influence her participation in subsequent screening.

OBJECTIVE

The purpose of this study was to determine the association between a woman's satisfaction with her initial screening experience and compliance to biennial screening at centers with and without nurses.

METHODS

A stratified random sample of compliers and noncompliers to biennial screening was selected from a cohort of 16 858 eligible women aged 50 to 65 years attending centers with and without nurses for their initial screen at the Ontario Breast Screening Program in 2002. Of these eligible women, 3387 were sent questionnaires, 2640 (77.9%) were contacted, and 1901 (72.0%) were interviewed. The association between satisfaction with initial screen and compliance was estimated separately for centers with and without nurses using logistic regression.

RESULTS

Women attending centers with nurses were significantly less likely to comply with their next screen after their clinical breast examination if they were not completely satisfied with the service they received (odds ratio, 0.21; 95% confidence interval, 0.08-0.57) or agreed that the clinical breast examination caused discomfort to their breasts (odds ratio, 0.65; 95% confidence interval, 0.45-0.94). In addition, women attending centers with or without nurses were significantly less likely to comply if they did not understand why they needed to return for screening.

CONCLUSIONS

: Nurses at screening centers have an opportunity to significantly impact a woman's compliance to biennial breast screening by providing a positive initial screening experience.

IMPLICATIONS FOR PRACTICE

Emphasis should be placed on improving a woman's overall satisfaction with her initial screening experience.

Influence of perceived breast cancer risk on screening behaviors of female relatives from the Ontario site of the Breast Cancer Family Registry

Few studies have examined the influence of perceived risk on breast screening behaviors among women with an increased familial breast cancer risk. This study included 1019 women aged 20-71 years from the Ontario site of the Breast Cancer Family Registry who had at least one first-degree relative diagnosed with breast and/or ovarian cancer. Information was obtained from a self-administered questionnaire completed at the time of recruitment and a follow-up telephone questionnaire. The associations between breast screening behaviors and perceived risk of developing breast cancer, measured on both a numerical and Likert-type verbal scale, were estimated using logistic regression analyses. Women who rated their risk of developing breast cancer as greater than 50% compared with less than 50% were significantly more likely to have a screening mammogram within the last 12 months (odds ratio: 1.91; 95% confidence interval: 1.15-3.16). Women were significantly more likely to have a screening mammogram (odds ratio: 1.82; 95% confidence interval: 1.17-2.81) in the past 12 months if they rated their risk as above or much above average compared with same as average or below. These findings may inform educational messages for improving risk communication of women at elevated familial breast cancer risk.

The role of clinical breast examination and breast self-examination

The efficacy of screening by clinical breast examination (CBE) and/or breast self-examination (BSE) is reviewed using indirect evidence from randomized breast screening trials and that from observational studies. In countries where breast cancer is diagnosed at an advanced stage, screening by CBE with the teaching of BSE as an integral component will probably be effective in reducing breast cancer mortality. However, in technically advanced countries where adequate treatment is given, no screening modality is likely to be sufficiently beneficial to outweigh the harms of screening, especially false positives and over-diagnosis.