Speakers
David French
David French is Professor of Health Psychology at the University of Manchester. He has published over 250 articles in peer-reviewed journals, and has received research funding of over £100 million from bodies including European Commission, MRC and NIHR. He was co-PI with Prof Gareth Evans for the PROCAS-2 NIHR programme grant, developing an evidence base to inform a decision to implement risk stratified screening within the NHS breast screening programme. He was an author and Scientific Advisory Group member for the 2021 update of MRC/ NIHR guidance on Development and Evaluation of Complex Interventions (third edition). He was a panel member for Research Excellence Framework (REF) 2021, sub-panel 2: Public Health, Health Services and Primary Care. He was co-Editor for the Psychological Society journal: British Journal of Health Psychology for 5 years. He has recently been elected President of the European Health Psychology Society.
Acceptability and impact of personalised breast screening for women invited and healthcare professionals
It is possible to accurately estimate breast cancer risk for women of screening age, and thereby provide tailored screening and prevention offers according to risk estimates. I will present a series of linked studies from a NIHR-funded programme that concerned the feasibility of incorporating this into the NHS Breast Screening Programme.
In 2019-2021, risk stratification via the BC-Predict system was offered by three screening services to 19,464 women in North West England, of whom 14,661 attended screening (60.7%). Only 2,429 women (12.5%) who were eligible took up the offer of BC-Predict. This figure was lower than expected, probably due to the effects of the COVID-19 pandemic. When personally approached, 137/263 (52.0%) of women took up this offer.
A nested questionnaire study found no changes in general anxiety or cancer-related worry for women offered BC-Predict. Thematic analyses of qualitative interviews revealed women were positive about BC-Predict, with only transient increases in worry reported by women who were at high risk. Interviews with healthcare professionals that had been involved with the implementation found that they were generally enthusiastic, with their concerns elicited before implementation not materializing.
An agenda-setting meeting with 74 clinicians, researchers and those with national policy decision-making or implementation roles identified a consensual view that risk-stratified screening is likely to happen eventually. The European MyPeBS trial has recruited 53,143 women to examine effectiveness of risk-stratified screening at preventing later-stage (2+) breast cancers, which should report by 2027. It is now timely to develop plans to prepare for risk stratified screening.
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