title: Perceived breast cancer risk: heuristic reasoning and search for a dominance structure.
abstract: Studies suggest that people construct their risk perceptions by using inferential rules called heuristics. The purpose of this study was to identify heuristics that influence perceived breast cancer risk. We examined 11 interviews from women of diverse ethnic/cultural backgrounds who were recruited from community settings. Narratives in which women elaborated about their own breast cancer risk were analyzed with Argument and Heuristic Reasoning Analysis methodology, which is based on applied logic. The availability, simulation, representativeness, affect, and perceived control heuristics, and search for a dominance structure were commonly used for making risk assessments. Risk assessments were based on experiences with an abnormal breast symptom, experiences with affected family members and friends, beliefs about living a healthy lifestyle, and trust in health providers. Assessment of the potential threat of a breast symptom was facilitated by the search for a dominance structure. Experiences with family members and friends were incorporated into risk assessments through the availability, simulation, representativeness, and affect heuristics. Mistrust in health providers led to an inappropriate dependence on the perceived control heuristic. Identified heuristics appear to create predictable biases and suggest that perceived breast cancer risk is based on common cognitive patterns.
authors.affiliation: Department of Physiological Nursing, University of California San Francisco (UCSF), 2 Koret Way, Box 0610, San Francisco, CA 94143, USA. mkatapo@itsa.ucsf.edu
authors.forename: Maria C
authors.initials: MC
authors.lastname: Katapodi
authors.forename: Noreen C
authors.initials: NC
authors.lastname: Facione
authors.forename: Janice C
authors.initials: JC
authors.lastname: Humphreys
authors.forename: Marylin J
authors.initials: MJ
authors.lastname: Dodd
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000523:psychology*; D003657:Decision Making; D004198:Disease Susceptibility / Q000145:classification; D005260:Female; D015438:Health Behavior; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008128:Logic; D008875:Middle Aged; D033262:Narration; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D018570:Risk Assessment / Q000379:methods*; D016387:Women's Health