Exploring Women's Perceptions of Their Risk of Developing Breast Cancer

摘要

The study described perceived breast cancer risk compared subjective and objective risk estimates and examined the influence of heuristic reasoning in women's narratives. The survey used three probability scales (Verbal Comparative Numerical) and the Gail model to measure perceived and objective risk. Aim 3 was addressed with argument and heuristic reasoning analysis. We recruited a multicultural educated sample of 184 English-speaking women from community settings. Fifty four provided an in-depth interview. Participants held an optimistic bias regarding their breast cancer risk (comparative optimism and better-than-average) and underestimated their objective risk calculated with the Gail model. Breast cancer worry was a significant predictor of breast cancer risk. Better-educated and higher-income women reported lower levels of worry while Black women were more likely than Asian and White women to report higher levels of worry but not higher levels of perceived risk. Most participants did not know that older age is a breast cancer risk factor and older women did not perceive higher risk. These findings imply that women's knowledge of breast cancer risk factors was incomplete despite their high educational level. Age and family history are independent predictors of sporadic and hereditary/familial breast cancer risk; yet women could not distinguish between the two forms of the disease. Most participants (70%) were adherent to mammography and clinical breast exam (CBE) screening guidelines which can be attributed to high access to screening services and efforts from health care providers. Age having health insurance and higher 5-year Gail scores were significant predictors of frequency of screening mammograms and CBEs. Distrust of the health system was the single most important predictor of predisposition to use health services which in turn was another significant predictor of screening mammograms and CBEs.