Predictors of pessimistic breast cancer risk perceptions in a primary care population.
OBJECTIVE
To identify sociodemographic characteristics, numeracy level, and breast cancer risk factors that are independently associated with the accuracy of lifetime and 5-year breast cancer risk perceptions.


METHODS
Cross-sectional survey. A probability scale was used to measure lifetime and 5-year risk perceptions. The absolute difference between perceived risk and the Gail model risk of breast cancer was calculated. Linear regression models were built to predict lifetime and 5-year breast cancer risk estimation error.


METHODS
Primary care internal medicine practices (N = 2).


METHODS
Two hundred fifty-four women 40 to 85 years of age.


RESULTS
The mean lifetime and 5-year calculated breast cancer risk was 8.4% (SD [standard deviation] 6.1) and 1.5% (SD 1.3), respectively. Subjects had a mean estimation error for lifetime and 5-year risk of 29.5% (SD 22.9) and 24.8% (SD 23.9), respectively. In multivariate analyses, lower numeracy scores (0.005), higher number of previous breast biopsies (0.016), and a higher number of first-degree relatives (0.054) were predictive of larger estimation error for lifetime breast cancer risk. White race (0.014), lower educational levels (0.009), higher number of previous breast biopsies (0.008), and higher number of first-degree relatives (0.014) were predictive of larger estimation error for 5-year risk.


CONCLUSIONS
Among a primary care population, breast cancer risk factors may be more consistently associated with pessimistic perceptions of breast cancer risk than other factors studied during a lifetime and 5-year time span. Primary care physicians should consider counseling patients about individual breast cancer risk factors and risk over time.
Davids
Susan L
SL
Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. sdavids@mail.mcw.edu
Schapira
Marilyn M
MM
McAuliffe
Timothy L
TL
Nattinger
Ann B
AB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011320:Primary Health Care; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors