"Abstract

Background

Risk-stratified breast cancer screening has been proposed as an alternative to the age-based approach currently used by most screening programs. This study, part of the Canadian PERSPECTIVE I&I project, examined perceived advantages and disadvantages of learning your breast cancer risk category and associated screening plans.

Method

Women aged 40-69 from Ontario and Quebec (N=3,319) had multifactorial risk assessments using the CanRisk tool. Risk categories (average [78.9%], higher than average [16.4%], high [4.6%]) were communicated along with screening plans. Participants completed questionnaires on attitudes toward learning their risk before, at the time of, and one year later risk communication. Participant characteristics associated with these attitudes were assessed using multinomial logistic regression.

Results

At the time of risk communication, most participants (72.9%) perceived "Easing worry" as an advantage of learning their risk. However, participants at higher risk were more likely to report that it did not ease their worry. Visible minority participants (OR = 1.86, 95% CI 1.16, 2.98) and those with lower education attainment were more likely to view “complicated information” as a disadvantage (College/Apprenticeship/Trades: OR = 1.54, 95% CI 1.24, 1.92; High School or below: OR = 1.77, 95% CI 1.29, 2.42). Ontario participants were more likely to view risk communication as “information I do not want to know” (OR = 0.44, 95% CI 0.32, 0.59) compared to Quebec participants.

Conclusion

Most women responded positively to learning their breast cancer risk category and screening plan. Successful implementation of risk-stratified screening will require clear communication, healthcare provider support, and adaptation to regional resources.

Micro Abstract

In a Canadian study of 3,319 women aged 40–69, most responded positively to receiving personalized breast cancer risk categories and screening plans. While “easing worry” was commonly perceived as an advantage, higher-risk and marginalized groups reported more concerns. Findings highlight the need for clear communication and tailored support to ensure effective implementation of risk-stratified screening."