Evaluation of a risk-stratified breast cancer screening decision aid (DEFINE) among Breast-Screen Victoria clients revealed increased knowledge, acceptance of risk-based screening, and willingness to reduce screening frequency, potentially aiding program evolution.

The study published in NPJ Breast Cancer in 2023 investigated the impact of a risk-based breast screening decision aid on various aspects of women’s engagement with breast cancer screening. As breast cancer screening approaches shift towards a more personalized, risk-stratified model, it becomes crucial to assess how women understand, accept, and make decisions regarding their screening.

The researchers developed a decision aid called DEFINE based on women’s perspectives, values, and knowledge about risk-stratified breast cancer screening. They conducted a pre and post-survey among 127 participants from Breast-Screen Victoria, who completed an online questionnaire before and after reviewing the decision aid. Notably, this was part of a larger pool of 3,200 potential participants.

The results showed that exposure to the DEFINE decision aid led to significant improvements in participants’ knowledge about breast cancer screening, greater acceptance of risk-stratified approaches, and a willingness to consider less frequent screening for those at lower risk. Importantly, the study found high levels of acceptance for risk stratification, genetic testing, and tailored screening both before and after the decision aid intervention.

Overall, these findings suggest that the DEFINE decision aid positively influenced women’s acceptance of less frequent screening, which is a crucial aspect of implementing risk-stratified breast cancer screening programs. This study may contribute to the evolution of population-based breast screening programs in Australia and beyond.


  1. Source: Lippey J, Keogh L, Campbell I, Mann GB, Forrest LE. Impact of a risk based breast screening decision aid on understanding, acceptance and decision making. NPJ Breast Cancer. 2023 Aug 8;9(1):65.
  2. Springer Nature Limited