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Background: Personalized breast cancer screening is a novel strategy that estimates individual risk based on age, breast density, family history of breast cancer, personal history of benign breast lesions, and polygenic risk. Its goal is to propose personalized early detection recommendations for women in the target population based on their individual risk. Our aim was to synthesize the factors that influence women’s decision to participate in personalized breast cancer screening, from the perspective of women and health care professionals. Methods: Systematic review of qualitative evidence on factors influencing participation in personalized Breast Cancer Screening. We searched in Medline, Web of science, Scopus, EMBASE, CINAHL and PsycINFO for qualitative and mixed methods studies published up to March 2022. Two reviewers conducted study selection and extracted main findings. We applied the best-fit framework synthesis and adopted the Multilevel influences on the cancer care continuum model for analysis. After organizing initial codes into the seven levels of the selected model, we followed thematic analysis and developed descriptive and analytical themes. We assessed the methodological quality with the Critical Appraisal Skills Program tool. Results: We identified 18 studies published between 2017 and 2022, conducted in developed countries. Nine studies were focused on women (n= 478) and in four studies women had participated in a personalized screening program. Nine studies focused in health care professionals (n= 162) and were conducted in primary care and breast cancer screening program settings. Factors influencing women’s decision to participate relate to the women themselves, the type of program (personalized breast cancer screening) and perspective of health care professionals. Factors that determined women participation included persistent beliefs and insufficient knowledge about breast cancer and personalized screening, variable psychological reactions, and negative attitudes towards breast cancer risk estimates. Other factors against participation were insufficient health care professionals knowledge on genetics related to breast cancer and personalized screening process. The factors that were favourable included the women’s perceived benefits for themselves and the positive impact on health systems. Conclusion: We identified the main factors influencing women’s decisions to participate in personalized breast cancer screening. Factors related to women, were the most relevant negative factors. A future implementation requires improving health literacy for women and health care professionals, as well as raising awareness of the strategy in society.

Evaluar el efecto de recibir información sobre los beneficios y los efectos adversos del cribado del cáncer de mama en la elección informada, en función del nivel educativo.

La consolidación de los programas poblacionales de detección precoz de cáncer de mama y el debate sobre el balance entre el beneficio y el riesgo han juntado la oportunidad y la necesidad de investigación para mejorar la efectividad de los mismos. En España, en paralelo a otros países con programas poblacionales, la investigación en cribado ha evolucionado desde los primeros estudios descriptivos de participación hasta los estudios longitudinales sobre efectos adversos como falsos positivos y cáncer de intervalo, y estudios para conocer mejor el riesgo individual de presentar un cáncer de mama, aprovechando la información que ofrecen las cohortes de mujeres cribadas. Además, se han desarrollado nuevas metodologías de investigación que permiten evaluar nuevas estrategias de cribado, aún teóricas, basadas en el riesgo individual. Por último, se están empezando a desarrollar herramientas de ayuda a la toma de decisiones para facilitar el proceso de informar de forma individualizada a las mujeres.

El cáncer de mama es la primera causa de muerte en el mundo entre las mujeres. El Sistema Nacional de Salud (SNS) introdujo el cribado poblacional de cáncer de mama en 1990. Como en la mayoría de los programas europeos, el riesgo se identifica con base en la edad y se ofrece una mamografía cada dos años a mujeres de 50 a 69 años. La evidencia científica está avanzando hacia un cribado personalizado, basado en el riesgo individual. En este artículo se presentan los ensayos clínicos que evaluarán la eficacia del cribado personalizado y algunos estudios realizados en nuestro entorno sobre el efecto de informar a las mujeres de los beneficios y efectos adversos del cribado o la aceptabilidad y viabilidad de ofrecer cribado personalizado, que incluya la toma de decisiones compartidas. El Programa de Actividades Preventivas y Promoción de la Salud puede ayudar a transformar el cribado en nuestro SNS.

To assess the prognostic performance of general severity systems (APACHE II [acute physiology and chronic health evaluation], simplified acute physiology score [SAPS II], and mortality probability models [MPM II]) in coronary patients and to derive new customized indexes for coronary patients using a reduced number of variables.

Our goal was to compare in-phase (IP) and opposed-phase (OP) GRE and conventional SE sequences in T1-weighted (T1-W) imaging of the liver and to evaluate chemical shift GRE imaging in characterizing liver/lesions for fat content.