The impact of a family history of breast cancer on screening practices and attitudes in low-income, rural, African American women.
BACKGROUND
Women with a family history of breast cancer are at increased risk for developing cancer and, therefore, might be expected to engage in early detection practices more actively than women without a family history. Alternatively, women with a family history may avoid thinking about cancer and have attitudes and practices that do not promote early detection.


METHODS
This study examined breast cancer attitudes and practices among African American women aged >or=50 who had not had a mammogram in the last 2 years.


RESULTS
Phone survey data from 320 female clients of low-income, rural primary care clinics (91% African American) indicated that 15% self-reported a family history of breast cancer (FH(+)). Half of the FH(+) women did not know their relative risk of developing breast cancer. Of those providing a risk estimate, 67% perceived themselves at low risk compared with other women their age. Perceived relative risk was comparable between FH(+) and FH(-) women. Further, FH(+) women did not indicate greater worry about breast cancer, nor did they have more accurate knowledge of mammography recommendations than FH(-) women. Two thirds of FH(+) women had never had a mammogram. Monthly breast self-examination did not differ between FH(+) and FH(-) women.


CONCLUSIONS
Thus, neither knowledge of a positive family history nor perceived relative risk of breast cancer was associated with either increased or decreased early detection practices among these low-income, rural, African American women who have underused mammography. Furthermore, a substantial proportion of FH(+) women had not ever participated in screening mammography. Interventions to increase mammography rates in this population of underusers are indicated.
West
Delia Smith
DS
University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205-7199, USA. dswest1@uams.edu
Greene
Paul G
PG
Kratt
Polly P
PP
Pulley
Leavonne
L
Weiss
Heidi L
HL
Siegfried
Nicole
N
Gore
Stacy A
SA
D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000407:Alabama; D044383:Black People / Q000235:genetics; D001943:Breast Neoplasms / Q000208:ethnology / Q000235:genetics / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D020022:Genetic Predisposition to Disease; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008327:Mammography / Q000523:psychology* / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011203:Poverty; D012423:Rural Health