No abstract

BackgroundAs the risks and benefits of early detection and primary prevention strategies for breast cancer are beginning to be quantified, the risk perception of women has become increasingly important as may affect their screening behaviors. This study evaluated the women’s breast cancer risk perception and their accuracy, and determined the factors that can affect their risk perception accuracy.MethodsData was collected in a cross-sectional survey design. Questionnaire, including breast cancer risk factors, risk perceptions and screening behaviors, answered by 624 women visiting primary health care center (PHCC). “Perceived risk” investigated with numeric and verbal measures. Accuracy of risk perception was determined by women’s Gail 5-year risk scores.ResultsThe mean age of the participants was 59.62 ± 1.97 years. Of the women 6.7% had a first-degree relative with breast cancer, 68.9% performed breast self-examination and 62.3% had a mammography, and 82.9% expressed their breast cancer worry as “low”. The numeric measure correlated better with worry and Gail scores. Of the women 65.5% perceived their breast cancer risk accurately. Among the women in “high risk” group 65.7% underestimated, while in “average risk” group 25.4% overestimated their risk.ConclusionsTurkish women visiting PHCC are overtly and overly optimistic. This was especially obvious with the result that nearly one third had had no mammography. There is a need for further studies to understand why and how this optimism is maintained so that better screening strategies can be applied at PHCC. All health workers working at PHCC have to be aware of this optimism to prevent missed opportunities for cancer screening.

Screening recommendations of physicians are important for women to raise awareness about their risk factors and to promote appropriate screening behaviors. However, it seems challenging for primary care physicians (PCPs) to balance disease prevention and diagnosis, treatment. The objective of this study was to describe physicians' breast cancer consultancy practice including family history, cancer prevention issues for the women they care. This cross-sectional study included 577 women aged above 45 years, free of breast cancer, during their visits to their PCPs. Nearly half of the women reported their visit to PCPs for an annual examination during the year. Among them, 36.1% had first-degree relatives with cancer and 7.3% with breast cancer. But they reported to be asked about family history of cancer and informed about cancer prevention issues 35.1 and 26.4%, respectively. Cancer still seems to be a hard issue to be discussed, even with women visiting PCPs for annual examination. Asking first-degree relative with breast cancer can give PCPs the chance of determining women with increased risk and support women's appropriate understanding of their own risk in relation to their family history. This routine can make shared-decision making for developing person-centered approach for breast cancer screening possible. Further studies are needed for better understanding of loss of consultancy leadership of physicians for breast cancer.

BACKGROUND Remote consultations help reduce the level of contact between people and prevent cross-contamination. Little is known about the changes in consultation in European rural primary care during the Covid-19 pandemic. OBJECTIVE The purpose of our mixed method cross sectional study was to find out more about the effects of Covid-19 pandemic on patient consultation in European primary care. METHODS Key informant survey from sixteen member countries of the European Rural and Isolated Practitioners Association using a 48-item questionnaire. Proportions were calculated for dichotomized or categorized data, and means were calculated for continuous data. Multivariate analysis by logistic regression model was used to assess the association of multiple variables. RESULTS We collected questionnaires from 406 primary care informants in 16 European countries; 245 respondents (60.5%) were females. 152 PC informants were rural (37.5%), 124 semi-rural (30.5%). Mean age of the respondents was 45.9 years (SD 11.30) while seniority (mean) was 18.2 years (SD 11.6). 381 (93.8 %) of the respondents were medical doctors. Significant differences were found between countries in adopting alternative arrangements for face-to-face consultation: remote teleconsultation is well appreciated by both healthcare professionals and patients, but the most common way of remote consultation remains telephone consultation. A factor significantly inversely associated with the adoption of video consultation was the seniority of the primary care health care personnel OR: 1.19, 95% CI (1.02-1.40) P=0.03. CONCLUSIONS Telephone consultation is the most common form of remote consultation. The adoption of video-consultation is inversely related to the seniority of the informants.