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The acceptability of addressing alcohol consumption as a modifiable risk factor for breast cancer: a mixed method study within breast screening services and symptomatic breast clinics

The acceptability of addressing alcohol consumption as a modifiable risk factor for breast cancer: a mixed method study within breast screening services and symptomatic breast clinics
The acceptability of addressing alcohol consumption as a modifiable risk factor for breast cancer: a mixed method study within breast screening services and symptomatic breast clinics

Objectives Potentially modifiable risk factors account for approximately 23% of breast cancers, with obesity and alcohol being the two greatest. Breast screening and symptomatic clinical attendances provide opportunities ('teachable moments') to link health promotion and breast cancer-prevention advice within established clinical pathways. This study explored knowledge and attitudes towards alcohol as a risk factor for breast cancer, and potential challenges inherent in incorporating advice about alcohol health risks into breast clinics and screening appointments. Design A mixed-method study including a survey on risk factors for breast cancer and understanding of alcohol content. Survey results were explored in a series of five focus groups with women and eight semi-structured interviews with health professionals. Setting Women attending NHS Breast Screening Programme (NHSBSP) mammograms, symptomatic breast clinics and healthcare professionals in those settings. Participants 205 women were recruited (102 NHSBSP attenders and 103 symptomatic breast clinic attenders) and 33 NHS Staff. Results Alcohol was identified as a breast cancer risk factor by 40/205 (19.5%) of attenders and 16/33 (48.5%) of staff. Overall 66.5% of attenders drank alcohol, and 56.6% could not estimate correctly the alcohol content of any of four commonly consumed alcoholic drinks. All women agreed that including a prevention-focussed intervention would not reduce the likelihood of their attendance at screening mammograms or breast clinics. Qualitative data highlighted concerns in both women and staff of how to talk about alcohol and risk factors for breast cancer in a non-stigmatising way, as well as ambivalence from specialist staff as to their role in health promotion. Conclusions Levels of alcohol health literacy and numeracy were low. Adding prevention interventions to screening and/or symptomatic clinics appears acceptable to attendees, highlighting the potential for using these opportunities as teachable moments'. However, there are substantial cultural and systemic challenges to overcome if this is to be implemented successfully.

alcohol, breast cancer, mixed methods, risk factor, survey
2044-6055
Sinclair, Julia
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
McCann, Mark
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Sheldon, Ellena
dc5652d8-c335-4186-b270-8e12b5352123
Gordon, Isabel
037e821c-82c0-48eb-a9bc-e0c4eaa515ed
Brierley-Jones, Lyn
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Copson, Ellen
a94cdbd6-f6e2-429d-a7c0-462c7da0e92b
Sinclair, Julia
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
McCann, Mark
fa0c319a-4b6c-4882-985a-cd99748e379f
Sheldon, Ellena
dc5652d8-c335-4186-b270-8e12b5352123
Gordon, Isabel
037e821c-82c0-48eb-a9bc-e0c4eaa515ed
Brierley-Jones, Lyn
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Copson, Ellen
a94cdbd6-f6e2-429d-a7c0-462c7da0e92b

Sinclair, Julia, McCann, Mark, Sheldon, Ellena, Gordon, Isabel, Brierley-Jones, Lyn and Copson, Ellen (2019) The acceptability of addressing alcohol consumption as a modifiable risk factor for breast cancer: a mixed method study within breast screening services and symptomatic breast clinics. BMJ Open, 9 (6), [e027371]. (doi:10.1136/bmjopen-2018-027371).

Record type: Article

Abstract

Objectives Potentially modifiable risk factors account for approximately 23% of breast cancers, with obesity and alcohol being the two greatest. Breast screening and symptomatic clinical attendances provide opportunities ('teachable moments') to link health promotion and breast cancer-prevention advice within established clinical pathways. This study explored knowledge and attitudes towards alcohol as a risk factor for breast cancer, and potential challenges inherent in incorporating advice about alcohol health risks into breast clinics and screening appointments. Design A mixed-method study including a survey on risk factors for breast cancer and understanding of alcohol content. Survey results were explored in a series of five focus groups with women and eight semi-structured interviews with health professionals. Setting Women attending NHS Breast Screening Programme (NHSBSP) mammograms, symptomatic breast clinics and healthcare professionals in those settings. Participants 205 women were recruited (102 NHSBSP attenders and 103 symptomatic breast clinic attenders) and 33 NHS Staff. Results Alcohol was identified as a breast cancer risk factor by 40/205 (19.5%) of attenders and 16/33 (48.5%) of staff. Overall 66.5% of attenders drank alcohol, and 56.6% could not estimate correctly the alcohol content of any of four commonly consumed alcoholic drinks. All women agreed that including a prevention-focussed intervention would not reduce the likelihood of their attendance at screening mammograms or breast clinics. Qualitative data highlighted concerns in both women and staff of how to talk about alcohol and risk factors for breast cancer in a non-stigmatising way, as well as ambivalence from specialist staff as to their role in health promotion. Conclusions Levels of alcohol health literacy and numeracy were low. Adding prevention interventions to screening and/or symptomatic clinics appears acceptable to attendees, highlighting the potential for using these opportunities as teachable moments'. However, there are substantial cultural and systemic challenges to overcome if this is to be implemented successfully.

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More information

Accepted/In Press date: 26 March 2019
e-pub ahead of print date: 17 June 2019
Published date: June 2019
Keywords: alcohol, breast cancer, mixed methods, risk factor, survey

Identifiers

Local EPrints ID: 432843
URI: http://eprints.soton.ac.uk/id/eprint/432843
ISSN: 2044-6055
PURE UUID: edc507f1-6277-415d-889f-a64539033992
ORCID for Julia Sinclair: ORCID iD orcid.org/0000-0002-1905-2025

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Date deposited: 30 Jul 2019 16:30
Last modified: 06 Jun 2024 01:36

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Contributors

Author: Julia Sinclair ORCID iD
Author: Mark McCann
Author: Ellena Sheldon
Author: Isabel Gordon
Author: Lyn Brierley-Jones
Author: Ellen Copson

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