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5 results on '"Rué, Montserrat"'

1. "For and against" factors influencing participation in personalized breast cancer screening programs: a qualitative systematic review until March 2022.

Author

Laza, Celmira, Niño de Guzmán, Ena, Gea, Montserrat, Plazas, Merideidy, Posso, Margarita, Rué, Montserrat, Castells, Xavier, and Román, Marta

Subjects
EARLY detection of cancer, MEDICAL personnel, BREAST cancer, GENETICS of breast cancer, HEALTH literacy, MEDICAL screening, ESTROGEN
Abstract

Background: Personalized breast cancer screening is a novel strategy that estimates individual risk based on age, breast density, family history of breast cancer, personal history of benign breast lesions, and polygenic risk. Its goal is to propose personalized early detection recommendations for women in the target population based on their individual risk. Our aim was to synthesize the factors that influence women's decision to participate in personalized breast cancer screening, from the perspective of women and health care professionals. Methods: Systematic review of qualitative evidence on factors influencing participation in personalized Breast Cancer Screening. We searched in Medline, Web of science, Scopus, EMBASE, CINAHL and PsycINFO for qualitative and mixed methods studies published up to March 2022. Two reviewers conducted study selection and extracted main findings. We applied the best-fit framework synthesis and adopted the Multilevel influences on the cancer care continuum model for analysis. After organizing initial codes into the seven levels of the selected model, we followed thematic analysis and developed descriptive and analytical themes. We assessed the methodological quality with the Critical Appraisal Skills Program tool. Results: We identified 18 studies published between 2017 and 2022, conducted in developed countries. Nine studies were focused on women (n = 478) and in four studies women had participated in a personalized screening program. Nine studies focused in health care professionals (n = 162) and were conducted in primary care and breast cancer screening program settings. Factors influencing women's decision to participate relate to the women themselves, the type of program (personalized breast cancer screening) and perspective of health care professionals. Factors that determined women participation included persistent beliefs and insufficient knowledge about breast cancer and personalized screening, variable psychological reactions, and negative attitudes towards breast cancer risk estimates. Other factors against participation were insufficient health care professionals knowledge on genetics related to breast cancer and personalized screening process. The factors that were favourable included the women's perceived benefits for themselves and the positive impact on health systems. Conclusion: We identified the main factors influencing women's decisions to participate in personalized breast cancer screening. Factors related to women, were the most relevant negative factors. A future implementation requires improving health literacy for women and health care professionals, as well as raising awareness of the strategy in society. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Views of health professionals on risk-based breast cancer screening and its implementation in the Spanish National Health System: A qualitative discussion group study.

Author

Laza-Vásquez, Celmira, Codern-Bové, Núria, Cardona-Cardona, Àngels, Hernández-Leal, Maria José, Pérez-Lacasta, Maria José, Carles-Lavila, Misericòrdia, and Rué, Montserrat

Subjects
MEDICAL personnel, EARLY detection of cancer, BREAST cancer, WOMEN'S roles, MEDICAL screening, PRIMARY care
Abstract

Background: With the aim of increasing benefits and decreasing harms, risk-based breast cancer screening has been proposed as an alternative to age-based screening. This study explores barriers and facilitators to implementing a risk-based breast cancer screening program from the perspective of health professionals, in the context of a National Health Service. Methods: Socio-constructivist qualitative research carried out in Catalonia (Spain), in the year 2019. Four discussion groups were conducted, with a total of 29 health professionals from primary care, breast cancer screening programs, hospital breast units, epidemiology units, and clinical specialties. A descriptive-interpretive thematic analysis was performed. Results: Identified barriers included resistance to reducing the number of screening exams for low-risk women; resistance to change for health professionals; difficulties in risk communication; lack of conclusive evidence of the benefits of risk-based screening; limited economic resources; and organizational transformation. Facilitators include benefits of risk-based strategies for high and low-risk women; women's active role in their health care; proximity of women and primary care professionals; experience of health professionals in other screening programs; and greater efficiency of a risk-based screening program. Organizational and administrative changes in the health system, commitment by policy makers, training of health professionals, and educational interventions addressed to the general population will be required. Conclusions: Despite the expressed difficulties, participants supported the implementation of risk-based screening. They highlighted its benefits, especially for women at high risk of breast cancer and those under 50 years of age, and assumed a greater efficiency of the risk-based program compared to the aged-based one. Future studies should assess the efficiency and feasibility of risk-based breast cancer screening for its transfer to clinical practice. [ABSTRACT FROM AUTHOR]

Published
2022
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3. The effect of information about the benefits and harms of mammography on women's decision-making: study protocol for a randomized controlled trial

Author

Carles, Misericòrdia, Martínez-Alonso, Montserrat, Pons, Anna, Pérez-Lacasta, Maria José, Perestelo-Pérez, Lilisbeth, Sala Serra, Maria, Vidal, Carmen, García, Montse, Toledo-Chávarri, Ana, Codern Bové, Núria, Feijoo-Cid, Maria, Romero, Anabel, Pla, Roger, Soler-González, Jorge, Castells, Xavier, Rué, Montserrat, and InforMa Group

Subjects
Research design, Health Knowledge, Attitudes, Practice, Mama -- Càncer -- Prevenció, Medicine (miscellaneous), Choice Behavior, law.invention, Study Protocol, Breast cancer screening, 0302 clinical medicine, Breast cancer, Randomized controlled trial, Risk Factors, law, Mass Screening, Medicine, Pharmacology (medical), 030212 general & internal medicine, Overdiagnosis, lcsh:R5-920, medicine.diagnostic_test, Mama -- Radiografia, Early detection, Middle Aged, Radiation Exposure, Cribratge, Research Design, 030220 oncology & carcinogenesis, Screening, Female, lcsh:Medicine (General), Mammography, medicine.medical_specialty, Medical screening, Decision Making, education, Breast Neoplasms, Radiation Dosage, Risk Assessment, Càncer de mama, Access to Information, 03 medical and health sciences, Patient Education as Topic, Predictive Value of Tests, Humans, Patient participation, Mass screening, Gynecology, business.industry, medicine.disease, Informed choice, Spain, Family medicine, Decision aids, Pamphlets, Patient Participation, business
Abstract

Background The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening on decision-making, in women approaching the age of invitation to mammography screening. Methods A two-stage, randomized controlled trial (RCT). In the first stage, 40 Basic Health Areas (BHAs) will be selected and randomized to intervention or control. In the second stage, women within each BHA will be randomly selected (n = 400). Four breast cancer screening programs (BCSPs) of the Spanish public health system, three in Catalonia and one in the Canary Islands will participate in the study. Women in the intervention arm will receive a leaflet with detailed information on the benefits and harms of screening using mammography. Women in the control arm will receive a standard leaflet that does not mention harms and recommends accepting the invitation to participate in the biennial examinations of the BCSP. The primary outcome is informed choice, a dichotomous variable that combines knowledge, attitudes, and intentions. Secondary outcomes include decisional conflict; confidence in the decision made; anxiety about screening participation; worry about breast cancer; anticipated regret; time perspective; perceived importance of benefits/harms of screening; perceived risk of breast cancer; and leaflet acceptability. Primary and secondary outcomes are assessed 2–3 weeks after the intervention. Discussion This is the first RCT that assesses the effect of informing about the benefits and harms of breast cancer screening in Spain in women facing the decision to be screened using mammography. It aims to assess the impact of information on several decisional outcomes and to contribute to paving the road towards shared decision-making in breast cancer screening in our country. Trial registration ClinicalTrials.gov registry, ID: NCT03046004. Retrospectively registered on 4 February 2017. Trial name: InforMa study. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2161-7) contains supplementary material, which is available to authorized users.

Published
2017

4. Situación de la investigación en el cribado de cáncer de mama en España: implicaciones para la prevención = Current status of research in breast cancer screening in Spain: implications for prevention

Author

Sala i Serra, Maria, Salas Trejo, Dolores, Zubizarreta, Raquel, Ascunce, Nieves, Rué, Montserrat, Castells Cervelló, Xavier, RAFP (Grup d'estudi), RAFP Digital (Grup d'estudi), and INCA (Grup d'estudi)

Subjects
Breas t-- Cancer -- Prevention, Medical screening, Mama -- Càncer -- Prevenció, Cribatge (Medicina)
Abstract

Grupo de estudio RAFP: IMIM-Hospital del Mar, Parc de Salut Mar, Barcelona: Xavier Castells, Francesc Macià, Marta Román, María Sala. Servicio de programas poblacionales de cribado, Xunta de Galicia: Raquel Almazán, Ana Belén Fernández, María Teresa Queiro, Raquel Zubizarreta. Programa de Detección Precoz de Cáncer de Mama de Navarra, Instituto de Salud Pública, Pamplona: Nieves Ascunce, María Ederra, Nieves Erdozain, Iosu Delfrade. Dirección General de Salud Pública y Centro Superior de Investigación en Salud Pública (CSISP), Generalitat Valenciana: Dolores Cuevas, Josefa Ibáñez, Josefa Miranda, Dolores Salas. Servicio Canario de la Salud, Islas Canarias: María Obdulia de la Vega, Isabel Díez de la Lastra. Fundació Lliga per a la Recerca i Prevenció del Càncer, Institut d’Investigació Sanitària Pere Virgili, Reus, Tarragona: Jaume Galceran. Unidad de Análisis y Programas, Departamento de Salud, Asturias: Carmen Natal. Programa de Detección Precoz de Cáncer de Mama, La Rioja. Fundación Rioja Salud, Logroño: Araceli Baroja. Sección de Promoción y Protección de la Salud. Corporació Parc Taulí-Institut Universitari Parc Taulí (UAB), Sabadell: Marisa Baré. Castilla-León Programa de Detección Precoz de Cáncer de Mama. Dirección General de Salud Pública ID e I. SACYL. Castilla y León: Isabel González-Román Grupo de estudio RAFP Digital: IMIM-Hospital del Mar, Parc de Salut Mar, Barcelona: Francesc Belvis, Xavier Castells, María Sala. Hospital Santa Caterina, Girona: Joana Ferrer. Dirección General de Salud Pública y Centro Superior de Investigación en Salud Pública (CSISP), Generalitat Valenciana: Josefa Ibáñez, María Soledad Laso, Dolores Salas. Cantabria: Mar Sánchez, Alfonso Vega Grupo de estudio INCA: IMIM-Hospital del Mar, Parc de Salut Mar, Barcelona: Jordi Blanch, Xavier Castells, Mercè Comas, Laia Domingo, Francesc Macià, Juan Martínez, Marta Román, Anabel Romero, María Sala. Dirección General de Salud Pública y Centro Superior de Investigación en Salud Pública (CSISP), Generalitat Valenciana: Carmen Alberich, Josefa Ibáñez, Amparo Lluch, Josefa Miranda, Dolores Salas, Ana Torrella. Servicio de Programas Poblacionales de Cribado, Xunta de Galicia: Raquel Almazán, Miguel Conde, Montserrat Corujo, Ana Belén Fernández, Raquel Zubizarreta. Servicio de Programas Oncológicos, Servicio Canario de la Salud: Teresa Barata, Isabel Díez de la Lastra, Juana María Reyes. Programa de Detección Precoz del Cáncer de Mama-Osakidetza, País Vasco: Arantza Otegi, Garbiñe Sarriugarte. Hospital Parc Taulí, Sabadell: Marisa Baré, Núria Torà. Hospital Santa Caterina, Girona: Joana Ferrer, Gemma Renart. Registro de Cáncer de Girona, Institut Català d’Oncologia: Rafael Marcos-Gragera, Montserrat Puig. Universitat de Lleida: Carles Forné, Montse Martínez-Alonso, Albert Roso, Montse Rué, Ester Vilaprinyó. Universitat Rovira i Virgili, Tarragona: Misericordia Carles, Aleix Gregori, María José Pérez. Regió Sanitària Terres de l’Ebre: Roger Pla The consolidation of breast cancer screening programs, with full coverage of the target population in all Spanish regions, has encouraged the beginning of a joint research strategy. This strategy aims to improve the effectiveness of breast cancer screening by gathering information from distinct screening programs. Methods A retrospective cohort with information on over 1.5 million screened women was constructed to evaluate risk factors for a false-positive result. The impact of the change from digital mammography to screen-film mammography was evaluated, while results for interval cancers and false negatives are currently being studied. Results The results are highly useful from the perspective of public health, as they can be used to identify and improve the information provided to women with a higher risk of experiencing an adverse effect. These results will also be helpful to identify screening program-related characteristics and women's personal characteristics, which will allow better prevention strategies to be developed. Conclusions The results obtained will be included in mathematical models currently under development to evaluate the efficiency of breast cancer screening. These models could be highly useful to provide information and guide clinical and health policy decisions on cancer prevention and control La finalización del despliegue de los programas de detección precoz de cáncer de mama en todas las comunidades autónomas de España ha facilitado el inicio de una investigación conjunta, con información procedente de varios programas, orientada a mejorar su efectividad. Métodos Se ha construido una cohorte de más de 1 millón de mujeres cribadas para evaluar el riesgo y los determinantes de los resultados falsos positivos. Se ha evaluado el impacto del cambio de técnica de mamografía analógica a digital y se está estudiando el cáncer de intervalo y los resultados falsos negativos. Resultados Los resultados ofrecen información muy útil, desde el punto de vista de salud pública, para identificar e informar mejor a las mujeres con mayor riesgo de presentar efectos adversos, a la vez que ayudará a identificar características ligadas a los programas y a las mujeres que permitan establecer mejores estrategias de prevención. Conclusiones Estos resultados se incorporarán a los modelos matemáticos sobre evaluación de la eficiencia de los programas que se están desarrollando actualmente. Modelos que pueden ser de gran utilidad como herramienta dirigida a informar y guiar las decisiones clínicas y de planificación sanitaria sobre el control del cáncer

Published
2012

5. Frequentist and Bayesian approaches for a joint model for prostate cancer risk and longitudinal prostate-specific antigen data.

Author

Serrat, Carles, Rué, Montserrat, Armero, Carmen, Piulachs, Xavier, Perpiñán, Hèctor, Forte, Anabel, Páez, Álvaro, and Gómez, Guadalupe

Subjects
*BAYESIAN analysis, *PROSTATE cancer, *DIAGNOSIS, *MEDICAL screening, *RELATIVE medical risk, *BAYES' theorem, *ANTIGENS
Abstract

The paper describes the use of frequentist and Bayesian shared-parameter joint models of longitudinal measurements of prostate-specific antigen (PSA) and the risk of prostate cancer (PCa). The motivating dataset corresponds to the screening arm of the Spanish branch of the European Randomized Screening for Prostate Cancer study. The results show that PSA is highly associated with the risk of being diagnosed with PCa and that there is an age-varying effect of PSA on PCa risk. Both the frequentist and Bayesian paradigms produced very close parameter estimates and subsequent 95% confidence and credibility intervals. Dynamic estimations of disease-free probabilities obtained using Bayesian inference highlight the potential of joint models to guide personalized risk-based screening strategies. [ABSTRACT FROM PUBLISHER]

Published
2015
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