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Breast cancer is the most commonly diagnosed cancer among Latinas. Dominican women in particular have a higher lifetime risk of breast cancer than do other Latinas in the U.S. This study examines how gender, ethnic, and language concordance between providers and patients are associated with recent mammography screening for Latina immigrant women from the Dominican Republic. We conducted structured interviews, in Spanish, with 419 Dominican women aged 40 years or older living in New York City. Using bivariate analysis and logistic regressions, we tested whether patient-provider gender, ethnic, and language concordance was associated with recent mammography when controlling for demographic covariates, breast cancer screening knowledge, and self-rated health. Gender concordance predicted recent mammography after controlling for covariates (β = 0.13). Neither ethnic nor language concordance significantly predicted recent mammography. Our findings suggest that promotion of patient-provider gender concordance may help reduce health disparities among Latinos/as and other minority groups across the United States. [ABSTRACT FROM AUTHOR]

Aims and objectives: To obtain feedback regarding the comprehension and acceptability of an information leaflet on breast cancer screening among women. Background: Women usually receive a leaflet inviting them to participate in breast cancer screening programmes for early detection of breast cancer. These leaflets include relevant information about mammograms to aid with decision‐making. It is important to know how the target population perceives these leaflets, as this may influence the attitude towards breast cancer screening. Design: A mixed‐methods study (concurrent triangulation design). Methods: Participants were 41 women aged between 40–60 years in the north of Spain. The leaflet included information about breast cancer, mammograms, benefits/risks of screening, and the breast cancer mortality and survival rates in relation to screening. Three written methods were used to assess the leaflet: a readability assessment (Flesch Index) and two comprehension assessments (Cloze and multiple‐choice questions). In addition, 26 semi‐structured interviews were conducted to explore the women's opinions regarding comprehension, acceptability and the contribution of the leaflet as a decision aid. The COREQ checklist was used to guarantee the quality and rigour of the qualitative study. Results: Overall, women found the leaflet fairly easy to read and most understood the content. Some women found the information on mortality alarming, difficult to understand and a cause for rejection. The leaflet was viewed as a decision aid, although further information was requested on mammograms, the need for complementary tests and the risks and symptoms of breast cancer. Conclusion: The leaflet was accepted by women and, overall, easy to understand. The participation of the target population enabled the content and format of the leaflet to be adjusted to their needs. Relevance for clinical practice: Nurses can contribute towards improving the breast cancer screening leaflets, considering women's perceptions surrounding screening. [ABSTRACT FROM AUTHOR]

Objective: We aimed to explore whether the type of mammographic feature prompting a false-positive recall (FPR) during mammography screening influences the risk and timing of breast cancer diagnosis, particularly if assessed with invasive procedures.Study Design: We included information on women screened and recalled for further assessment in Spain between 1994 and 2015, with follow-up until 2017, categorizing FPRs by the assessment (noninvasive or invasive) and mammographic feature prompting the recall.Main Outcome Measures: Breast cancer rates in the first two years after FPR (first period) and after two years (second period).Results: The study included 99,825 women with FPRs. In both periods, the breast cancer rate was higher in the invasive assessment group than in the noninvasive group (first period 12 ‰ vs 1.9 ‰, p < 0.001; second period 4.4‰ vs 3.1‰, p < 0.001). During the first period, the invasive assessment group showed diverse breast cancer rates for each type of mammographic feature, with a higher rate for asymmetric density (31.9‰). When the second period was compared with the first, the breast cancer rate decreased in the invasive assessment group (from 12‰ to 4.4‰, p < 0.001) and increased in the noninvasive assessment group (from 1.9‰ to 3.1‰, p < 0.001).Conclusion: In the context of mammography screening, the risk of breast cancer diagnosis during the first two years after FPR was particularly high for women undergoing invasive assessment; importantly, the risk was modified by type of mammographic feature prompting the recall. This information could help to individualize follow-up after exclusion of malignancy. [ABSTRACT FROM AUTHOR]

Objectives: Breast cancer remains a public health problem worldwide. Early detection through mammography practice has been shown to be effective in improving survival among women. Nevertheless, it is necessary to have high participation in mammography screening to achieve that goal. The aim of this study is to estimate the adherence to recommended preventive practices for breast cancer (mammography) in Spain and to identify predictors of uptake according to sociodemographic variables, health related variables and lifestyles. Study design: This is a descriptive cross-sectional study based on data from the European Health Interview Survey for Spain. Breast cancer screening included self-reported mammography in the last two years. The age target range was 40-69 years (n = 5771). The following independent variables were analysed: sociodemographic (marital status, educational level, monthly income, and nationality), visit to a general practitioner, chronic conditions and lifestyles. Predictors of mammography adherence were explored using multivariate logistic regression. Results: The screening coverage in the target population was 67.7% (95% CI: 66.2-69.1). Mammography uptake was positively associated with being married, higher educational and income levels, Spanish nationality, having visited a general practitioner in the previous four weeks and suffering from musculoskeletal disease. Otherwise, the youngest age group studied (40-49 years) and obesity was associated with lower adherence to mammography. Conclusions: Compliance with mammography practice in Spain is acceptable to achieve the goal of reducing mortality from breast cancer among women. However significant inequalities in uptake of breast screening in Spain were found. Future campaigns must aim to improve participation especially among women with disadvantaged socio-economic situations and immigrants. [ABSTRACT FROM AUTHOR]

Abstract: Aims of the study: The Gail Model (GM) is the most well-known model to assess the individual risk of breast cancer (BC). Although its discriminatory accuracy is low in the clinical context, its usefulness in the screening setting is not well known. The aim of this study is to assess the utility of the GM in a European screening program. Methods: Retrospective cohort study of 2200 reassessed women with information on the GM available in a BC screening program in Barcelona, Spain. The 5 year-risk of BC applying the GM right after the screening mammogram was compared first with the actual woman''s risk of BC in the same screening round and second with the BC risk during the next 5 years. Results: The curves of BC Gail risk overlapped for women with and without BC, both in the same screening episode as well as 5 years afterward. Overall sensitivity and specificity in the same screening episode were 22.3 and 86.5%, respectively, and 46.2 and 72.1% 5 years afterward. ROC curves were barely over the diagonal and the concordance statistics were 0.59 and 0.61, respectively. Conclusion: The GM has very low accuracy among women with a positive mammogram result, predicting BC both in the concomitant episode and 5 years later. Our results do not encourage the use of the GM in the screening context to aid the referral decision or the type of procedures after a positive mammogram or to identify women at high risk among those with a false-positive outcome. [Copyright &y& Elsevier]

Objective: Satisfaction represents the subjective experience derived from the fulfillment or non-fulfillment of the expectations that the subject has regarding assistance. The debate generated by the screening programs requires studying satisfaction as one more element in the evaluation. In 2006, a study was carried out in Barcelona on the satisfaction and expectations generated around screening. Ten years later another was carried out in order to study evolution during this time. The objective of the current study is to investigate the satisfaction with the Breast Cancer Screening Program (BCSP) in Barcelona and to compare with the results obtained in a previous study carried out 10 years ago., Methods: This was a cross-sectional study, whose study population was women participating in the BCSM. We conducted random sampling. The questionnaire asked for opinion about the informative materials and the information sessions, their level of participation (regular or irregular) and their overall satisfaction with the program. Women who had been referred for further examinations were asked specific questions about their satisfaction with the follow-up process. We conducted a descriptive analysis and compare the results to those obtained in the 2006 survey. We assessed the correlation between satisfaction and importance using the Pearson's correlation coefficient, and we also performed logistic regression analyses. All statistical analyses were conducted using SPSS., Results: Participants were generally satisfied with the program, the professionalism and treatment received from the medical professionals. There was a significant positive correlation with the importance given to each of these dimensions. Women who stated that they did not feel nervous while waiting for the results of the mammography reported that they felt very satisfied with the information received [OR=1.86 (95% CI 1.03-3.36)] and with the equipment used [OR=1.97 (1.02-3.85)]. Non-working women were more satisfied with the information obtained [OR=1.86 (CI 1.06-2.9)]. Most of the results showed improvement with respect to those of the 2006 survey., Conclusions: It's necessary to continue working towards providing the best possible information, and paying special attention to the most vulnerable groups., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Communication is a corner stone of population-based breast cancer screening programs that need to invite all the women from their target population and provide them with balanced information on screening to guaranty informed participation. Invited women also need to be able to contact screening programs to get further information on screening procedures and/or cancel and reschedule appointments. This study describes the communication channels used by women invited for breast cancer screening to contact the program. The study population consisted of 141,684 women, aged 50–69 years, who were invited during 2015–2016 for screening by the Catalan Breast Cancer Screening Program (Spain). Multiple logistic regression models were performed to assess the association between age, screening history, socioeconomic status and reasons for contacting the program and the outcome variables (contact with the program; contact through information and communication technology (ICT) channels). Among the 141,684 women invited for BC screening, 22.5% contacted the screening office mainly to reschedule (42.2%) and cancel (29.2%) appointments. While the communication channel mostly used was the telephone, 24.8% of the women used ICT. ICT was more frequently used by women who had never been screened. Women who wanted to change their appointment were 65% (OR 1.65, 95%CI 1.54–1.76) more likely to use ICT than women who wanted to cancel it. This study showed the need to reinforce communication between women and breast cancer screening programs and the importance of offering communication channels suiting all women's needs to facilitate appointments' rescheduling and cancelling and therefore improve screening programs' efficiency. [ABSTRACT FROM AUTHOR]

This qualitative study evaluates a decision aid that includes the benefits and harms of breast cancer screening and analyses women's perception of the information received and healthcare professionals' perceptions of the convenience of providing it. Seven focus groups of women aged 40-69 years (n = 39) and two groups of healthcare professionals (n = 23) were conducted in Catalonia and the Canary Islands. The focus groups consisted of guided discussions regarding decision-making about breast cancer screening, and acceptability and feasibility of the decision aid. A content analysis was performed. Women positively value receiving information regarding the benefits and harms of breast cancer screening. Several women had difficulties understanding some concepts, especially those regarding overdiagnosis. Women preferred to share the decisions on screening with healthcare professionals. The professionals noted the lack of inclusion of some harms and benefits in the decision aid, and proposed improving the clarity of the statistical information. The information on overdiagnosis generates confusion among women and controversy among professionals. Faced with the new information presented by the decision aid, the majority of women prefer shared decision-making; however, its feasibility might be limited by a lack of knowledge and attitudes of rejection from healthcare professionals., (© 2017 John Wiley & Sons Ltd.)