{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:07:08Z","timestamp":1791594428926,"version":"4.3.4"},"reference-count":49,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"unspecified","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014733","name":"Association of Breast Surgery","doi-asserted-by":"crossref","award":["LW declares sponsorship from"],"award-info":[{"award-number":["LW declares sponsorship from"]}],"id":[{"id":"10.13039\/100014733","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,17]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine whether satisfaction with information provision and involvement in decision-making among people with breast cancer (BC) treated in English hospitals was associated with age and other patient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective population-based cohort study, conducted as part of the National Audit of Primary Breast Cancer and the National Audit of Metastatic Breast Cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>National Cancer Patient Experience Survey (CPES) responses linked to National Cancer Registration data for BC patients (stage 0\u20134) diagnosed between 2017 and 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>40 018 patients diagnosed with BC who responded to CPES between 2017 and 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Responses to questions about overall experience of care, satisfaction with information provision, involvement in decision-making and clinical nurse specialist (CNS) contact were examined. The relationships between responses, personal, disease and clinical characteristics were analysed using multivariable Poisson regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>90% of patients rated their overall care as \u22658 out of 10 (0=very poor; 10=very good), decreasing to 82% for those aged &lt;40 years (p&lt;0.001). Adjusted analysis showed that stage 4 disease (incidence risk ratio (IRR) 1.19; CI 1.02 to 1.40; p&lt;0.001), the highest deprivation (IRR 1.18; CI 1.07 to 1.30; p&lt;0.001) and Asian (IRR 1.60; CI 1.42 to 1.82; p&lt;0.001) or Black (IRR 1.53; CI 1.30 to 1.80; p&lt;0.001) ethnicity were associated with a negative overall care experience. Satisfaction was high for information provision (85%) and involvement in decisions (81%), but lower among younger patients and those with advanced stage disease (both p&lt;0.001). Fewer than 70% of patients aged &lt;40 years felt sufficiently involved in decisions, compared with 81% &gt;40 years (p&lt;0.001). Patients with stage 4 disease were more likely to report dissatisfaction with involvement in decision-making (IRR 1.50: CI 1.36 to 2.67; p&lt;0.001). Most patients (95%) had a named CNS, with 85% reporting ease of contact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most patients reported high satisfaction with their BC care. Satisfaction was consistently lower among younger people and those with advanced disease; this finding might partly reflect more complex pathways but requires further exploration, ideally in partnership with patients to codesign solutions. Actionable remedial strategies are proposed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-110564","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T15:26:01Z","timestamp":1778599561000},"page":"e110564","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Age, patient experience and satisfaction with breast cancer care: a cohort study using linked national cancer patient experience survey and cancer registry data"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3529-8260","authenticated-orcid":false,"given":"Sarah","family":"Blacker","sequence":"first","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"},{"name":"Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana R","family":"Withrow","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"},{"name":"Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-957X","authenticated-orcid":false,"given":"Jemma M","family":"Boyle","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2675-4703","authenticated-orcid":false,"given":"Liyang","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"},{"name":"Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5163-1716","authenticated-orcid":false,"given":"Christine","family":"Delon","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jibby","family":"Medina","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"Horgan","sequence":"additional","affiliation":[{"name":"Breast Surgery, St James\u2019s University Hospital, Leeds, West Yorkshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8787-4904","authenticated-orcid":false,"given":"David","family":"Dodwell","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Verrill","sequence":"additional","affiliation":[{"name":"Northern Centre for Cancer Care, Freeman Hospital, Newcastle-upon-Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4849-2430","authenticated-orcid":false,"given":"Agnieszka","family":"Lemanska","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK"},{"name":"Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam E","family":"Frampton","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Cromwell","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"},{"name":"Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"2026062608315534000_16.5.e110564.1","unstructured":"Picker . 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