The Relation Between Projected Breast Cancer Risk, Perceived Cancer Risk, and Mammography Use

Department of Medicine, Sections of General Internal Medicine, Yale University School of Medicine, New Haven, Conn, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 02/2006; 21(2):158-64. DOI: 10.1111/j.1525-1497.2005.00312.x
Source: PubMed


In summary, we found that routine mammography is underused at the national level. Although it is reassuring that women with the highest breast cancer risk were more likely to report routine mammography use than low risk women, there is substantial room for improvement in this population as 1 in 4 women in the highest group did not report routine mammography use. We also found that perceived risk was independently associated with routine mammography use, and that among women with increased projected cancer risk, white women were more likely to report increased perceived risk than Black or Hispanic women. While family history of breast cancer was strongly associated with perceived cancer risk, other risk factors such as age at first menarche, obesity, or prior abnormal mammography were either weakly related or unrelated to perceived risk. Our results suggest that when clinicians approach patients to discuss the use of mammography, it is important not only to convey risk estimates to patients, but also to ascertain their understanding of their risk and how they incorporate their risk preceptions into their plan of care. Particularly as the concept of tailoring screening strategies based on individualized risk profiles gain momentum, our results underscore the importance of patient education and communication. Once women are motivated to return for regular mammography, informed of how mammography can help them, and are able to access the health care system, they will then be able to receive the benefit promised by evidence and guidelines.

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