Communicating overdiagnosis in breast cancer screening: a randomized trial of a decision aid among women approaching target screening age.

Abstract: Mammography screening can reduce breast cancer mortality. However, most women are unaware that inconsequential disease can also be detected by screening, leading to over-diagnosis and over-treatment. We aimed to investigate whether including information about over-diagnosis of breast cancer in a decision aid would help women aged around 50 years to make an informed choice about breast screening. Women (n=879) aged 48-50 were randomized to 1 of 2 decision aids. Both booklets presented evidence based information on key screening outcomes (breast cancer mortality benefit and false positives); 1 booklet also included over-diagnosis information. Study outcomes included informed choice (knowledge, attitudes and intentions) decisional conflict, anxiety, worry, anticipated regret and acceptability of the decision aid. Implications for the effective communication of over-diagnosis in screening and the development of optimal strategies for future information delivery will be discussed.
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