Promoting early presentation of breast cancer by older women: a preliminary evaluation of a one-to-one health professional-delivered intervention.
Burgess CC., Linsell L., Kapari M., Omar L., Michell M., Whelehan P., Richards MA., Ramirez AJ.
OBJECTIVE: To test the early effects of a novel one-to-one health professional-delivered intervention designed to increase awareness and thereby promote early presentation of breast cancer among older women. METHODS: Women attending their final routine appointment in the English NHS Breast Screening Programme received a booklet or a booklet supplemented by a brief interview, in addition to usual care. This was a within-group before-and-after evaluation of the two versions of the intervention. The primary outcome was change in the knowledge of breast cancer symptoms from baseline to 1 month postintervention. Secondary outcomes were knowledge of risk of developing breast cancer, confidence to detect a breast change, and likelihood of disclosure to someone close. Levels of cancer worry and any adverse effects caused by the intervention were also monitored. RESULTS: One hundred seventy-six women received the booklet and 116 received the booklet-plus-interview. At 1-month postintervention, the mean number of breast cancer symptoms identified (out of 11) increased from 5.3 by 1 symptom (P<.001) in the booklet group and by 1.9 (P<.001) in the booklet-plus-interview group. Improvements were sustained at 6 months. Positive improvements were made in the knowledge of risk of developing breast cancer and the confidence to detect a breast change in both groups; however, neither version of the intervention had an impact on encouraging women to disclose to someone close immediately on discovery of a breast symptom. No adverse effects were reported, and there was no significant increase in the level of cancer worry. DISCUSSION: Both versions of the intervention are worthy of testing in randomized trials to assess the impact on breast cancer awareness and ultimately on delayed presentation of breast cancer and mortality.