Are women satisfied with their experience with breast cancer screening? Systematic review of the literature.

BACKGROUND: The evaluation of participant experience is an essential part of monitoring the quality of breast cancer screening services. Satisfaction of services can lead to good adherence and hence affect health outcomes. METHODS: We performed a systematic review to assess how satisfied women were with organized breast cancer screening programs. A literature search in Medline, CINAHL, Embase and PsycINFO from 1965 to October 2019 was performed. Articles reporting a quantitative measure of satisfaction collected via questionnaires in programs using mammography as a screening test were selected. We narratively synthesized the data and used tabulated summaries. RESULTS: Out of 4310 individual citations, 3099 abstracts were reviewed by two independent researchers, and 126 articles were selected for full-text reading. Finally, 48 studies, published between 1990 and 2018, were included in analysis, reporting 54 surveys in the context of an organized screening program, 37 on satisfaction with screening mammography, 14 on satisfaction with further assessments and 3 with counseling. Most studies reported a high level of satisfaction for both mammography and further assessments. Despite commonly reported temporary pain, discomfort and anxiety, the willingness to be re-screened was very high. Effective information transfer, the staff's interpersonal skills and quick delivery of results correlated with high satisfaction. Only 7 out of 54 surveys used recognized satisfaction instruments or their modifications. CONCLUSIONS: In general, satisfaction with breast cancer screening is high, but its evaluation is mainly performed using non-validated instruments. Emphasis should be put on effective communication, the staff´s interpersonal skills and quick delivery of results.

The importance of and satisfaction with sex life among breast cancer survivors in comparison with healthy female controls and women with mental depression or arterial hypertension: results from the Finnish nationwide HeSSup cohort study.

INTRODUCTION: Breast cancer (BC) and its treatment is associated with several physical and psychosocial changes that may influence sexuality for years after treatment. Women with BC show significantly greater rates of sexual dysfunction than do healthy women. The purpose of the study was to evaluate how a BC diagnosis associates with women's perceived sexuality and sexual satisfaction. MATERIAL AND METHODS: The data of the ongoing prospective Health and Social Support (HeSSup) survey was linked with national health registries. Respondents with registry data confirmed BC (n = 66), mental depression (n = 612), arterial hypertension (n = 873), and healthy women (n = 9731) formed the study population. The importance of and satisfaction with sex life were measured by a self-report questionnaire modified from the Schover's and colleagues' Sexual History Form. RESULTS: Women with BC considered sex life less important than did healthy women (p < 0.001). They were significantly less satisfied with their sex life than healthy women (p = 0.01) and women with arterial hypertension (p = 0.04). Living single or educational level did not explain the differences between the groups. CONCLUSIONS: BC survivors depreciate their sex life and experience dissatisfaction with it. Sexuality can be a critical issue for the quality of life of women surviving from BC, and hence, the area deserves major attention in BC survivorship care. Health care professionals should regularly include sexual functions in the assessment of BC survivors' wellbeing.

Systematic review on women's values and preferences concerning breast cancer screening and diagnostic services.

BACKGROUND: There is still lack of consensus on the benefit-harm balance of breast cancer screening. In this scenario, women's values and preferences are crucial for developing health-related recommendations. In the context of the European Commission Initiative on Breast Cancer, we conducted a systematic review to inform the European Breast Guidelines. METHODS: We searched Medline and included primary studies assessing women's values and preferences regarding breast cancer screening and diagnosis decision making. We used a thematic approach to synthesise relevant data. The quality of evidence was determined with GRADE, including GRADE CERQual for qualitative research. RESULTS: We included 22 individual studies. Women were willing to accept the psychological and physical burden of breast cancer screening and a significant risk of overdiagnosis and false-positive mammography findings, in return for the benefit of earlier diagnosis. The anxiety engendered by the delay in getting results of diagnostic tests was highlighted as a significant burden, emphasising the need for rapid and efficient screening services, and clear and efficient communication. The confidence in the findings was low to moderate for screening and moderate for diagnosis, predominantly because of methodological limitations, lack of adequate understanding of the outcomes by participants, and indirectness. CONCLUSIONS: Women value more the possibility of an earlier diagnosis over the risks of a false-positive result or overdiagnosis. Concerns remain that women may not understand the concept of overdiagnosis. Women highly value time efficient screening processes and rapid result delivery and will accept some discomfort for the peace of mind screening may provide.

Effects of rehabilitation among patients with advances cancer: a systematic review.

BACKGROUND: In parallel with the rising incidence of cancer and improved treatment, there is a continuous increase in the number of patients living with cancer as a chronic condition. Many cancer patients experience long-term disability and require continuous oncological treatment, care and support. The aim of this review is to evaluate the most recent data on the effects of rehabilitation among patients with advanced cancer. MATERIAL AND METHODS: A systematic review was conducted according to Fink's model. Only randomized controlled trials (RCTs) published in 2009-2014 were included. Medline/PubMed and Cochrane databases were searched; five groups of keywords were used. The articles were evaluated for outcome and methodological quality. RESULTS: Thirteen RCTs (1169 participants) were evaluated. Most studies were on the effects of physical exercise in patients with advanced cancer (N = 7). Physical exercise was associated with a significant improvement in general wellbeing and quality of life. Rehabilitation had positive effects on fatigue, general condition, mood, and coping with cancer. CONCLUSIONS: Rehabilitation is needed also among patients with advanced disease and in palliative care. Exercise improves physical performance and has positive effects on several other quality of life domains. More data and RCTs are needed, but current evidence gives an indication that rehabilitation is suitable and can be recommended for patients living with advanced cancer.

Influencing adolescents' attitudes towards nicotine products: A systematic review.

Background and aim: Use of nicotine can harm adolescents' brains and increase risk for future addiction to other drugs. Several international studies show that an acceptable attitude towards nicotine products increases the initiation or use of the products. Adolescents have limited or distorted knowledge about nicotine products. Many of them have a positive image of the properties and effects of nicotine products, which increases the chances of smoking or using snus. Yet, we know little about the relationship between youth nicotine use, youth attitudes towards nicotine products and the interventions to influence these attitudes. This systematic review synthesised adolescents' attitudes towards nicotine products and the ways to influence them. Methods: Systematic searches were carried out from PubMed, MEDLINE, CINAHL, and MEDIC databases and were targeted to randomised controlled trial (RCT) studies published in 2010-2021. Results: A total of seven RCT studies were reviewed with a total population (age range 9-17 years, adolescents 11-17 years) of 15,974. Findings were classified into four categories: school-based interventions, tobacco prevention campaigns, advertisements' influence on adolescents' opinions towards nicotine products, and their responses to cigarette pack warnings. Conclusion: Based on this systematic literature review, particularly school-based interventions have an effect on adolescents' attitudes towards smoking and preventing them from starting to smoke, when they are targeted before the age of puberty. School-based interventions should be further implemented and strengthened, as the school has been shown to have significant potential to support youth's health. There is a need for further information about the most effective interventions in the different age groups and the qualitative studies on the topic.

Validated tools measuring women's satisfaction in breast cancer screening programmes: A systematic review.

International guidelines recommend assessing women's satisfaction with breast cancer screening programmes; however, validated tools are needed. A systematic review to identify and evaluate the quality of validated instruments for screening satisfaction, from 01/1965 until 11/2017 was performed. From 3283 individual citations, six instruments were identified. Evaluation of the MammoGraphy Questionnaire using the COSMIN checklist resulted in 'good' to 'excellent' scores in most assessed domains, while the other tools were mostly 'poor'/'fair' quality or did not provide enough information for assessment. Nevertheless, substantial changes in screening processes and programmes have been implemented in recent years. Thus, further development work is needed.

Social support and breast cancer: A comparatory study of breast cancer survivors, women with mental depression, women with hypertension and healthy female controls.

OBJECTIVES: Among breast cancer (BC) survivors, inadequate social support (SS) is associated with a significant increase in cancer-related mortality and reduction in quality of life (QoL). The aim of the study was to explore perceived SS during BC trajectory by comparing BC survivors, women with depression, women with arterial hypertension, and healthy female controls to each other, and to compare perceived balance of receiving and providing SS. MATERIAL AND METHODS: The data of ongoing prospective postal survey was linked with national health registries. Respondents with BC (n = 64), depression (n = 471), arterial hypertension (n = 841) and healthy controls (n = 6274) formed the study population. SS was measured by a Sarason's 6-item shortened version of the Social Support Questionnaire (SSQ). The modified Antonucci's (1986) social support convoy model of the network of individuals was used to measure the dominating direction of SS. RESULTS: The main provider of SS for all participants combined was the spouse or partner (94.3%), close relative (12.0%) and friends (5.4%). In all groups, particularly in the BC and arterial hypertension group, spouse or partner was seen as the most important supporter. The group suffering from depression reported significantly less SS in each domain of appraisal (p < 0.001). In total, 24.6% of all respondents reported receipt dominance of SS. CONCLUSION: SS is a well-known determinant of wellbeing. Our study lends support to the spouse's or the partner's central role during the recovery phase of BC. Identification of factors improving the overall QoL of BC survivors is an important public health challenge.