The feasibility and acceptability of offering breast cancer risk assessment to general population women aged 30-39 years: A mixed-methods study protocol

Introduction: Breast cancer incidence starts to increase exponentially when women reach 30-39 years, hence before they are eligible for breast cancer screening. The introduction of breast cancer risk assessment for this age group could lead to those at higher risk receiving benefits of earlier screening and preventive strategies. Currently, risk assessment is limited to women with family history of breast cancer only. The BCAN-RAY study is evaluating a comprehensive breast cancer risk assessment strategy for women aged 30-39 years incorporating a questionnaire of breast cancer risk factors, low-dose mammography to assess breast density, and polygenic risk. The present study will assess the feasibility and acceptability of the BCAN-RAY risk assessment strategy. Methods and analysis: The present study involves women undergoing risk assessment as part of the BCAN-RAY case-control study (n = 750). They will be aged 30-39 years without a strong family history of breast cancer and invited to participate via general practice. A comparison of uptake rates by socioeconomic status and ethnicity between women who participate in the BCAN-RAY study and women who decline participation will be conducted. All participants will be asked to complete self-report questionnaires to assess key potential harms including increased state anxiety (STAI), cancer worry (Lerman Cancer Worry Scale), and satisfaction with decision to participate (Decision Regret Scale), alongside potential benefits such as feeling more informed about breast cancer risk. A sub-sample of approximately 24 women (12 at average risk and 12 at increased risk) will additionally participate in semi-structured interviews to understand the acceptability of the risk assessment strategy and identify any changes needed to it to increase uptake. Ethics and dissemination: Ethical approval was granted by North West - Greater Manchester West Research Ethics Committee (reference: 22/NW/0268). Study results will be disseminated through peer-reviewed journals, conference presentations and charitable organisations. Trial registration: NCT05305963