Reasons for (non)participation in supplemental population-based MRI breast screening for women with extremely dense breasts
de Lange, S. V.; Bakker, M. F.; Monninkhof, E. M.; Peeters, P. H.M.; de Koekkoek-Doll, P. K.; Mann, R. M.; Rutten, M. J.C.M.; Bisschops, R. H.C.; Veltman, J.; Duvivier, K. M.; Lobbes, M. B.I.; de Koning, H. J.; Karssemeijer, N.; Pijnappel, R. M.; Veldhuis, W. B.; van Gils, C. H.
(2018) Clinical Radiology, volume 73, issue 8, pp. 759.e1 - 759.e9
(Article)
Abstract
AIM: To determine the willingness of women with extremely dense breasts to undergo breast cancer screening with magnetic resonance imaging (MRI) in a research setting, and to examine reasons for women to participate or not. MATERIALS AND METHODS: Between 2011 and 2015, 8,061 women (50-75 years) were invited for supplemental
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MRI as part of the Dense Tissue and Early Breast Neoplasm Screening (DENSE) trial (ClinicalTrials.gov Identifier: NCT01315015), after a negative screening mammography in the national population-based mammography screening programme. Demographics of participants and non-participants were compared. All invitees were asked to report reasons for (non)participation. Ethical approval was obtained. Participants provided written informed consent. RESULTS: Of the 8,061 invitees, 66% answered that they were interested, and 59% eventually participated. Participants were on average 54-years old (interquartile range: 51-59 years), comparable to women with extremely dense breasts in the population-based screening programme (55 years). Women with higher socio-economic status (SES) were more often interested in participation than women with lower SES (68% versus 59%, p<0.001). The most frequently stated reasons for non-participation were "MRI-related inconveniences and/or self-reported contraindications to MRI" (27%) and "anxiety regarding the result of supplemental screening" (21%). "Expected personal health benefit" (68%) and "contribution to science" (43%) were the most frequent reasons for participation. CONCLUSION: Of women invited for MRI because of extremely dense breasts, 59% participated. Common reasons for non-participation were "MRI-related inconveniences" and "anxiety regarding the result of supplemental screening". In case of future implementation, availability of precise evidence on benefits and harms might reduce this anxiety.
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Keywords: Aged, Breast Density, Breast Neoplasms/diagnostic imaging, Early Detection of Cancer, Female, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging/methods, Mass Screening, Middle Aged, Netherlands, Patient Compliance, Risk Factors, Radiology Nuclear Medicine and imaging, Randomized Controlled Trial, Multicenter Study, Journal Article
ISSN: 0009-9260
Publisher: W.B. Saunders Ltd
Note: Funding Information: The authors acknowledge the study participants for their contributions. The authors thank the regional screening organisations, Volpara Solutions, the Dutch Expert Centre for Screening, and the National Institute for Public Health and the Environment for their advice and in-kind contributions for organising the breast density assessments and the invitation of potential participants. The DENSE trial is financially supported by the University Medical Center Utrecht (Project number: UMCU DENSE ), the Netherlands Organization for Health Research and Development (ZonMw, Project numbers: ZONMW-200320002-UMCU and ZonMW Preventie 50-53125-98-014 ), the Dutch Cancer Society (KWF Kankerbestrijding, Project numbers: DCS-UU-2009-4348 , UU-2014-6859 and UU2014-7151 ), the Dutch Pink Ribbon/A Sister's Hope (Project number: Pink Ribbon-10074 ), Bayer AG Pharmaceuticals, Radiology (Project number: BSP-DENSE ), and Stichting Kankerpreventie Midden-West . For research purposes, Volpara Solutions (Wellington, New Zealand) provided Volpara Imaging Software 1.5 for installation on servers in the screening units of the Dutch screening programme. Funding Information: The authors acknowledge the study participants for their contributions. The authors thank the regional screening organisations, Volpara Solutions, the Dutch Expert Centre for Screening, and the National Institute for Public Health and the Environment for their advice and in-kind contributions for organising the breast density assessments and the invitation of potential participants. The DENSE trial is financially supported by the University Medical Center Utrecht (Project number: UMCU DENSE), the Netherlands Organization for Health Research and Development (ZonMw, Project numbers: ZONMW-200320002-UMCU and ZonMW Preventie 50-53125-98-014), the Dutch Cancer Society (KWF Kankerbestrijding, Project numbers: DCS-UU-2009-4348, UU-2014-6859 and UU2014-7151), the Dutch Pink Ribbon/A Sister's Hope (Project number: Pink Ribbon-10074), Bayer AG Pharmaceuticals, Radiology (Project number: BSP-DENSE), and Stichting Kankerpreventie Midden-West. For research purposes, Volpara Solutions (Wellington, New Zealand) provided Volpara Imaging Software 1.5 for installation on servers in the screening units of the Dutch screening programme. Funding Information: N.K. is a cofounder and shareholder of Volpara Health Technologies Solutions and Qview Medical (Los Altos, CA, USA) and CEO of ScreenPoint Medical (Nijmegen, NL). R.M.M. disclosed grants and non-financial support from Siemens Healthcare, grants and non-financial support from Seno Medical, grants from Identification Solutions, grants from Bayer Healthcare, grants from Elswood, and grants from Medtronic. The other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. Publisher Copyright: © 2018 The Royal College of Radiologists
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