Jolyn Hersch|Alexandra Barratt|Jesse Jansen|Les Irwig|Kevin McGeechan|Gemma Jacklyn|Hazel Thornton|Haryana M. Dhillon|Nehmat Houssami|Kirsten McCaffery
Use of a decision aid including information on overdetection to support informed choice about breast cancer screening: a randomised controlled trial
University of Sydney|University of Sydney|University of Sydney|University of Sydney|University of Sydney|University of Sydney|University of Leicester|University of Sydney|University of Sydney|University of Sydney
background mammography screening reduce breast cancer mortality however women unaware inconsequential disease also detected screening leading overdiagnosis overtreatment aimed investigate whether including information overdetection breast cancer decision aid would help women aged around 50 years make informed choice breast screening methods communitybased parallelgroup randomised controlled trial new south wales australia using random cohort women aged 4850 years recruitment study done telephone women eligible mammography past 2 years personal strong family history breast cancer computer program randomly assigned 879 participants either intervention decision aid comprising evidencebased explanatory quantitative information overdetection breast cancer mortality reduction false positives control decision aid including information breast cancer mortality reduction false positives participants interviewers masked group assignment primary outcome informed choice defined adequate knowledge consistency attitudes screening intentions assessed telephone interview 3 weeks random allocation primary outcome analysed women completed relevant followup interview questions fully trial registered australian new zealand clinical trials registry number actrn12613001035718 findings january 2014 july 2014 440 women allocated intervention group 439 assigned control group 21 women intervention group 20 controls lost followup ten women assigned intervention 11 controls answer questions attitudes therefore 409 women intervention group 408 controls analysed primary outcome 99 24 409 women intervention group made informed choice compared 63 15 408 control group difference 9 95 ci 314 p00017 compared controls women intervention group met threshold adequate overall knowledge 122419 29 vs 71419 17 difference 12 95 ci 618 p00001 fewer women expressed positive attitudes towards screening 282409 69 vs 340408 83 14 920 p00001 fewer women intended screened 308419 74 vs 363419 87 13 819 p00001 conceptual knowledge alone considered 203 50 409 women intervention group made informed choice compared 79 19 408 control group p00001 interpretation information overdetection breast cancer provided within decision aid increased number women making informed choice breast screening becoming better informed might mean women less likely choose screening funding australian national health medical research council