Bridging the gap in breast cancer screening: the role of primary care and person-centered care in a Polish regional survey

Breast cancer mortality in Poland shows a concerning upward trend, contrasting with the declines seen across much of Europe. While primary care is the frontline of the healthcare system, its role in breast cancer prevention remains underutilized. This study aimed to evaluate breast cancer literacy, screening participation, and the specific role of the family physician (FP) in fostering informed, person-centered screening decisions among women in the Małopolska region. A cross-sectional study was conducted (August 2024–June 2025) involving 302 women (aged 40–75) recruited from six primary care centers. Data was collected via face-to-face interviews. The study assessed symptom awareness (0–110 scale), sources of health information, and individual risk using the Breast Cancer Risk Assessment Tool (BCRAT). Multivariate linear regression identified factors associated with symptom literacy. The mean age was 57.9 years. While lifetime screening participation (mammography or ultrasound) was high at 78.5%, significant knowledge gaps persisted; 43.5% of participants incorrectly believed breast cancer risk remains constant regardless of age. Awareness of common symptoms like lumps was high, but “rash on the nipples” was the least recognized. Gynaecologists were the most frequent professional source (64.0%), while family physicians provided information to 40% of respondents. Notably, passive information channels such as leaflets and social media outranked primary care involvement, being utilized by over half of the participants. However, over 70% of women reported they had not discussed screening in detail with their FP. Furthermore, only one-third of participants were informed about the risks of overdiagnosis/overtreatment, highlighting a gap in the informed consent process. There is a significant discrepancy between high lifetime screening rates and the depth of patient clinical literacy and informed choice. Primary care centers represent a critical, yet under-leveraged, “preventive medical home.” To align Poland’s mortality trends with Europe, primary care must transition from passive recruitment to a person-centered model. This involves utilizing “teachable moments” during routine visits to provide targeted education on age-related risks and engaging in shared decision-making that addresses both the benefits and harms of screening.