Tailored risk notification for women with a family history of breast cancer.
BACKGROUND
Evidence indicates that although first-degree relatives of breast cancer cases are at increased risk of developing the disease themselves, they may be underutilizing screening mammography. Therefore, interventions to increase the use of mammography in this group are urgently needed.


METHODS
A randomized two-group design was used to evaluate an intervention to increase mammography use among women (N = 901) with at least one first-degree relative with breast cancer. A statewide cancer registry was used to obtain a random sample of breast cancer cases who identified eligible relatives. The mailed intervention consisted of personalized risk notification and other theoretically driven materials tailored for high-risk women.


RESULTS
An overall significant intervention effect was observed (8% intervention group advantage) in mammography at post-test. There was an interaction of the intervention with age such that there was no effect among women <50 years of age and a fairly large (20% advantage) effect among women 50+ and 65+. Health insurance, education, and having had a mammogram in the year before baseline assessment were positive predictors of mammography at post-test. Perceived risk, calculated risk, and relationship to index cancer case were not associated with mammography receipt.


CONCLUSIONS
The intervention was successful in increasing mammography rates among high-risk women 50+ years of age. Further work is needed to determine why it was ineffective among younger women.
Bastani
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Division of Cancer Prevention and Control Research, University of California at Los Angeles School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California 90095-6900, USA. bastani@ucla.edu
Maxwell
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Bradford
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Das
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Yan
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control*; D002140:California; D005260:Female; D020022:Genetic Predisposition to Disease; D006266:Health Education / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D011177:Postal Service; D012042:Registries; D018570:Risk Assessment