Table 1. Summary of included study characteristics and key findings.

Author & year:	Setting (country):	Relevant study aim(s):	Cancer type(s):	Sample size:	Type of HCP (N):	Study design:	Method of data collection:	Themes identified: (where applicable)	Primary conclusions:
Hann (2017) [30]	UK	To investigate UK HCPs’ knowledge of ovarian cancer genetics and other risk factors, as well as self-efficacy in discussing cancer risk and genetic testing with patients, in order to identify professional training needs, and explore attitudes towards population-based genetic testing and stratified risk management.	Ovarian	829	GP (32) Genetics specialist (44) Oncologist (45) Gynaecologist (15) Nurse specialist (6) Other (4)	Quantitative	Cross-sectional survey	NA	Mixed attitudes toward risk stratification for ovarian cancer. However, most HCPs were willing to discuss management options with patients.
Fürst (2018) [31]	Germany	To assist doctors and screening participants in participatory decision-making.	Breast	15	Gynaecologist (7) GP (2) Radiologist (3 Human geneticist (1) Public health service (2)	Qualitative	Focus group	1. Assessments of individualised screening. 2. Assessments of women’s need for counselling in mammography screening 2.0. 3. Assessments of the doctors’ counselling competence. 4. Assessments of implementation of individualised screening.	Mammography screening 2.0 was viewed positively by most participants, implementation was considered more critically. Concerns expressed over time burden, competence, and guidelines.
Rainey (2018) [32]	Netherlands, UK & Sweden	To ask professionals to consider risk-based breast cancer screening and prevention from the perspective of eligible women to evaluate acceptability.	Breast	44	Netherlands (17): Researcher (7) Clinician (5) Other (5) UK (15): Researcher (3) Clinician (9) Other (5) Sweden (12): Researcher (5) Clinician (6) Other (1)	Primary mixed methods	Digital concept mapping	1. Anxiety/worry. 2. Proactive approach. 3. Reassurance. 4. Lack of knowledge. 5. Organisation of risk assessment and feedback.	Dutch, British & Swedish professionals considered women’s decision-making regarding personalised breast cancer screening similarly to women themselves. This is important for shared decision making.
Puzhko (2019) [33]	Canada	To engage health professionals in an in-depth dialog to explore the feasibility of the proposed implementation strategies for this new personalized breast cancer screening approach.	Breast	11	Genetic counsellors (3) Family physicians (8)	Qualitative	Deliberative stakeholder consultation	1. Implementation of the program: a) Introduction of the program and access to screening, b) Communicating results of individual risk estimation, c) Perspectives on women’s decision-making regarding participation in the program, d) Obstacles to using the model in a family physicians office, e) Referring women for follow-up, f) Correct interpretation of the program and its advantages, g) Uncertainty about the difference between risk assessment and screening for disease. 2. Benefits of the program: a) Benefits for HCPs, b) Benefits for women.	Risk stratification requires more clarity in communication with HCPs. Engagement of HCPs or a centralised system may be needed to ensure success of a risk stratified programme.
McWilliams (2020) [34]	UK	To elicit the views of national healthcare policy decision-makers regarding implementation of less frequent screening intervals for women at low-risk.	Breast	17	Radiologist, oncologist, radiographer, nurse, or surgeon (6) Senior academics (6) Breast screening programme operations/ management professions (5)	Qualitative	Semi-structured interviews	1. Producing the evidence defining low risk: a) Overcoming reservations about evidence accuracy, b) Determining a risk threshold and interval length, c) Risk stratification should be cost-effective. 2. The impact of risk stratification on women: a) Managing women as individuals, b) Balancing the harms and benefits, c) The ability to make autonomous decisions. 3. Practically implementing a low-risk pathway: a) Initial feasibility, b) Communication is essential, c) Considering service implications.	National healthcare policy decision makers found risk-stratified breast cancer screening generally acceptable. Before implementation there is a need to provide evidence for the accurate identification of low-risk individuals, ensure acceptability from women, demonstrate lack of harm, and ensure screening programmes are capable of facilitating multiple pathways.
Blouin-Bougie (2021) [35]	Canada	To shed light on the perceptions of healthcare professionals regarding the implementation of a BC risk stratification population-based approach.	Breast	15	GP (6) MD specialists (5) Genetic counsellors (4)	Qualitative	Semi-structured interviews	1. WHO? Target population: a) Eligible participants. 2. HOW? Clinical activities & WHAT? Associated tools: a) Identification and invitation, b) Risk assessment, c) Risk communication, d) Risk management. 3. WHICH? Conditions or prerequisites: a) Ethical approach, b) Services organisation, c) Knowledge management, d) HR administration. 4. WHY? Potential effects: a) Patients or population, b) Services delivery.	Three main conditions to facilitate acceptability of breast cancer risk stratification: respecting equity, knowledge management, and reorganising HR to optimise the workforce. Respondents welcomed risk stratification and agreed about some of the potential benefits.
Woof (2021) [36]	UK	To elicit views regarding implementing less frequent screening for low-risk women from HCPs who implement risk-stratified screening.	Breast	28	Radiographer breast imaging manager (1) Breast screening office manager (1) Breast care nurse (1) Admin and data clerk (1) GP (3) Radiographer/ mammographer (16) Cancer screening improvement lead (2) Consultant radiologist (3)	Qualitative	Focus groups & telephone interviews	1. Reservations concerning the introduction of less frequent screening: a) Low-risk screening is logical in theory, b) Questioning the reliability of risk, c) Unease towards providing screening frequency, d) Low risk is not ‘no risk’. 2. Considerations for the management of public knowledge: a) Navigating media output, b) Navigating public scrutiny, c) Impact of mixed messaging and hearsay. 3. Deliberating service implications and reconfiguration management: a) Prevalent vs incident round rollout, b) Integrating a low-risk screening interval.	Risk stratification was considered a logical step towards personalised screening. Less frequent screening was not unacceptable but was considered mindfully.

BC–breast cancer

GP–general practitioner

HCP–healthcare provider/healthcare professional

HR–human resources

Mammography screening 2.0 –individualised mammography screening

MD–Doctor of Medicine