Evidence map›Paper›PMID 33871631›Full record

Trial reportJournal of the National Cancer Institute2021

Informing Women About Overdetection in Breast Cancer Screening: Two-Year Outcomes From a Randomized Trial.

Jolyn Hersch, Alexandra Barratt, Kevin McGeechan, Jesse Jansen, Nehmat Houssami, Haryana Dhillon, Gemma Jacklyn, Les Irwig, Kirsten McCaffery

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 4 pooled it
1.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024
    Pooled it
  4. The Impact of Morbidity and Disability on Attendance at Organized Breast Cancer-Screening Programs: A Systematic Review and Meta-Analysis.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022
    Pooled it
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  8. Article
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  12. How Do Australians Manage Diagnostic Testing Risks? Focus Groups Linked to a Model of Behaviour Change.Health expectations : an international journal of public participation in health care and health policy · 2024
    Article
  13. Observational
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  17. Overdetection of Breast Cancer.Current oncology (Toronto, Ont.) · 2022
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 2 countries.

Jolyn HerschSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0001-5225-6639
Alexandra BarrattSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Kevin McGeechanSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Jesse JansenWiser Healthcare: A Research Collaboration for Reducing Overdiagnosis and Overtreatment, The University of Sydney, Sydney, NSW, Australia.
Nehmat HoussamiSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0002-3641-952X
Haryana DhillonCentre for Medical Psychology and Evidence-based Decision-making, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Gemma JacklynWiser Healthcare: A Research Collaboration for Reducing Overdiagnosis and Overtreatment, The University of Sydney, Sydney, NSW, Australia.
Les IrwigSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Kirsten McCafferySchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0003-2696-5006
The University of Sydney · AU

Funding

Australian National Health and Medical Research Council (NHMRC 1062389NHMRC Early Career Fellowship 1112509NHMRC Investigator 1194410NHMRC Principal Research Fellowship 1121110
6 · The paper itself

Abstract

backgroundSupporting well-informed decisions about breast cancer screening requires communicating that inconsequential disease may be detected, leading to overdiagnosis and overtreatment. Having previously shown that telling women about overdetection improved informed choice, we investigated effects on screening knowledge and participation over 2 years.

methodsWe conducted a community-based, parallel-group, randomized controlled trial in Australia. Participants were women aged 48-50 years, without personal or strong family history of breast cancer, who had not undergone mammography in the past 2 years. We randomly assigned 879 women to receive the intervention decision aid (evidence-based information on overdetection, breast cancer mortality reduction, and false-positives) or control decision aid (identical but without overdetection information). We interviewed 838 women postintervention and recontacted them for follow-up at 6 months and 1 and 2 years. Main outcomes for this report are screening knowledge and participation.

resultsWe interviewed 790, 746, and 712 participants at 6 months, 1, and 2 years, respectively. The intervention group demonstrated superior knowledge throughout follow-up. After 2 years, conceptual knowledge was adequate in 123 (34.4%) of 358 women in the intervention group compared with 71 (20.1%) of 354 control participants(odds ratio = 2.04, 95% confidence interval = 1.46 to 2.85). Groups were similar in total screening participation (200 [55.1%] vs 204 [56.0%]; = 0.97, 95% confidence interval = 0.73 to 1.29).

conclusionsA brief decision aid produced lasting improvement in women's understanding of potential consequences of screening, including overdetection, without changing participation rates. These findings support the use of decision aids for breast cancer screening.

Indexed as

Breast NeoplasmsEarly Detection of CancerAustraliaFemaleHumansMammographyMass ScreeningMiddle Aged

Identifiers

PMID33871631
PMCPMC8562961
OpenAlexW3153122701

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.