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Could screening participation bias symptom interpretation? An interview study on women's interpretations of and responses to cancer symptoms between mammography screening rounds

Solbjør, Marit; Skolbekken, John-Arne; Sætnan, Ann Rudinow; Hagen, Anne Irene; Forsmo, Siri
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/2365042
Date
2012
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  • Institutt for samfunnsmedisin og sykepleie [1706]
  • Institutt for sosialt arbeid [478]
  • Publikasjoner fra CRIStin - NTNU [19694]
Original version
BMJ Open 2012, 2(6)   10.1136/bmjopen-2012-001508
Abstract
Objectives: To explore how women with negative mammography screening results, but who were later diagnosed with interval breast cancer, reacted when they observed breast symptoms that could indicate malignancy in-between screening rounds.

Design: Semistructured individual interviews with women who have been diagnosed with breast cancer during mammography screening intervals.

Setting: Two breast diagnostic units covering two counties in Norway.

Participants: 26 women diagnosed with interval breast cancer.

Results: Women with a screening negative result react in two ways when experiencing a possible symptom of breast cancer. Among 24 women with a self-detected palpable lesion, 14 sought medical advice immediately. Their argument was to dispose of potential cancer as soon as possible. Ten women delayed seeking medical advice, explaining their delay as a result of practical difficulties such as holidays, uncertainty about the symptom, and previous experiences of healthcare services’ ability to handle diffuse symptoms. Also, a recent negative mammography scan led some women to assume that the palpable lesion was benign and wait for the next screening round.

Conclusions: Participating in mammography screening may contribute to a postponed reaction to breast cancer symptoms, although most women acted rapidly when detecting a palpable breast lesion. Furthermore, screening participation does not necessarily increase awareness of breast cancer symptoms.
Publisher
BMJ Publishing Group
Journal
BMJ Open

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