Article Text

Download PDFPDF
Systematic review
Using a decision aid may prompt some younger women (38–50 years) to rethink breast cancer screening plans
  1. Jolyn Hersch,
  2. Kirsten McCaffery
  1. School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Jolyn Hersch, School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; jolyn.hersch{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Commentary on: Ivlev I, Hickman EN, McDonagh MS, et al. Use of patient decision aids increased younger women’s reluctance to begin screening mammography: a systematic review and meta-analysis. J Gen Intern Med 2017;32:802–13.

Implications for practice and research

  • Patient decision aids appear to increase the proportion of women aged 38–50 who do not intend to undergo breast cancer screening (8.5% absolute difference).

  • More high-quality research is needed, including large-scale randomised controlled trials in additional settings, with a focus on important outcomes such as knowledge and informed choice.


Mammographic screening for breast cancer may lead to both benefit (breast cancer mortality reduction) and harm (overdiagnosis of cancers that would never become clinically relevant, and false-positive screening results where no cancer is present). The trade-offs among these potential consequences of screening vary in magnitude and importance depending on women’s age, health and personal values. Patient decision aids (PtDAs) have therefore been recommended to help women understand these trade-offs and consider their informed preferences about whether to be screened. This systematic review and …

View Full Text


  • Twitter @jolynhersch

  • Funding Jolyn Hersch is supported by NHMRC Early Career Fellowship #1112509. Kirsten McCaffery is supported by NHMRC Career Development Fellowship #1029241.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.