A health professional-delivered one-to-one intervention to promote early presentation in breast cancer: a randomised controlled trial
Lindsay Forbes
Guy’s, King’s and St Thomas’ School of Medicine, London, UK
Background
We tested the efficacy of a health professional-delivered intervention aiming to equip older women with breast cancer knowledge and the skills and confidence to detect symptoms and seek help promptly, with the ultimate aim of promoting early presentation following breast cancer symptom discovery.
Method
We randomised 867 women aged 67-70 attending for their final routine appointment on the NHS Breast Screening Programme to receive either: a scripted ten-minute interaction with a health professional plus a booklet; or a booklet alone; or usual care. The primary outcome was whether or not a woman was breast cancer aware based on knowledge of breast cancer symptoms and age-related risk and reported breast checking. The women completed a trial-specific questionnaire at baseline, one month and six months later.
Results
Baseline levels of breast cancer awareness were low, especially knowledge of the increase in risk of breast cancer with age; the intervention had the most impact on this element of breast cancer awareness. At one month, the intervention increased the proportion who were breast cancer aware compared with usual care (interaction versus usual care: 33% versus 4%; odds ratio (OR) 24.0, 95% confidence interval (CI) 7.8 to 74.3; booklet versus usual care: 13% versus 4%; OR 4.4, 95%CI 1.6 to 11.9). At six months, women in the interaction group, but not the booklet group, continued to have significantly greater breast cancer awareness than those in the usual care group (26% versus 7%; OR 9.33, 95%CI 3.2 to 27.0).
Conclusion
The 10 minute interaction with a health professional improved breast cancer awareness at one month and six months compared with usual care. Future research will evaluate whether the intervention promotes early presentation and ultimately reduces breast cancer mortality.
