RT Journal Article
SR Electronic
T1 Benefits and harms of selective oestrogen receptor modulators (SERMs) to reduce breast cancer risk: a cross-sectional study of methods to communicate risk in primary care
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e836
OP e842
DO 10.3399/bjgp19X706841
VO 69
IS 689
A1 Jennifer G McIntosh
A1 Jesse Minshall
A1 Sibel Saya
A1 Adrian Bickerstaffe
A1 Nadira Hewabandu
A1 Ashleigh Qama
A1 Jon D Emery
YR 2019
UL http://bjgp.org/content/69/689/e836.abstract
AB Background In Australia, evidence-based guidelines recommend that women consider taking selective oestrogen receptor modulators (SERMs) to reduce their risk of breast cancer. In practice, this requires effective methods for communicating the harms and benefits of taking SERMs so women can make an informed choice.Aim To evaluate how different risk presentations influence women’s decisions to consider taking SERMs.Design and setting Cross-sectional, correlational study of Australian women in general practice.Method Three risk communication formats were developed that included graphics, numbers, and text to explain the reduction in breast cancer risk and risk of side effects for women taking SERMs (raloxifene or tamoxifen). Women aged 40–74 years in two general practices were shown the risk formats using vignettes of hypothetical women at moderate or high risk of breast cancer and asked to choose ‘If this was you, would you consider taking a SERM?’ Descriptive statistics and predictors (risk format, level of risk, and type of SERM) of choosing SERMs were determined by logistic regression.Results A total of 288 women were recruited (an 88% response rate) between March and May 2017. The risk formats that showed a government statement and an icon array were associated with a greater likelihood of considering SERMs relative to one that showed a novel expected frequency tree. Risk formats for raloxifene and for the high-risk vignettes were also more strongly associated with choosing to consider SERMs. No associations were found with any patient demographics.Conclusion Specific risk formats may lead to more women considering taking SERMs to reduce breast cancer risk, especially if they are at high risk of the condition. Raloxifene may be a more acceptable SERM to patients.