Barriers and facilitators to the implementation of a personalized breast cancer screening program: Views of Spanish health professionals

Abstract:This study explored the barriers and facilitators to the implementation of a risk-basedbreast cancer screening program from the point of view of Spanish health professionals. A cross-sectional study with 220 Spanish health professionals was designed. Data were collected in 2020 viaa web-based survey and included the advantages and disadvantages of risk-based screening andbarriers and facilitators for the implementation of the program. Descriptive statistics and Likert scaleresponses analyzed as category-ordered data were obtained. The risk-based screening was consideredimportant or very important to reduce breast cancer mortality and promote a more proactive role forwomen in breast cancer prevention, to increase coverage for women under 50 years, to promote abreast cancer prevention strategy for women at high risk, and to increase efficiency and effectiveness.Switching to a risk-based program from an age-based program was rated as important or veryimportant by 85% of participants. As barriers for implementation, risk communication, the workloadof health professionals, and limited human and financial resources were mentioned. Despite thebarriers, there is good acceptance, and it seems feasible, from the perspective of health professionals,to implement a risk-based breast cancer screening program in Spain. However, this poses a numberof organizational and resource challenges.This research was funded by Instituto de Salud Carlos III and co-funded by Fondo Europeode Desarrollo Regional (FEDER) ‘Una manera de hacer Europa’, grant numbers PI17/00834 andPI18/00773. C.L.-V. received a grant from Santander Program scholarship 2020 as a predoctoral fellowat the University of Lleida and M.J.H.-L. was supported by the European Regional Development Fund,European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curiegrant agreement No. 713679 from the Rovira i Virgili University. The funders did not participate inthe study design; collection, management, analysis, and interpretation of data; writing of the report;and the decision to submit the report for publicatio