title: Cancer screening and risk-reducing behaviors of women seeking genetic cancer risk assessment for breast and ovarian cancers.
abstract: OBJECTIVE
  To examine breast and ovarian cancer screening and risk-reducing behaviors of women seeking genetic cancer risk assessment (GCRA).
  
  
  METHODS
  Descriptive, cross-sectional.
  
  
  METHODS
  An insurance-based clinic that serves high-risk patients in a southern California cancer center.
  
  
  METHODS
  134 women with breast or ovarian cancer (affected group) and 80 women with a family history of breast or ovarian cancer (unaffected group). The mean age of the sample was 48 years (range = 21-86), 79% were Caucasian, 66% were married, 60% were college educated, and 78% had children. Most affected women had early-stage disease. Unaffected women had a family history of breast (86%) or ovarian (14%) cancer.
  
  
  METHODS
  Mailed surveys assessed pre-GCRA health behaviors and health and family histories.
  
  
  METHODS
  Breast cancer screening (mammograms, clinical breast examination [CBE], breast self-examination), ovarian cancer screening (CA-125, pelvic ultrasound), and breast and ovarian cancer risk-reducing strategies (tamoxifen, bilateral mastectomy, oral contraceptive pills, bilateral salpingo-oophorectomy).
  
  
  RESULTS
  Twenty-one percent of the women who should have been having a mammogram had not had an annual examination as recommended, and 30% of affected women had not had annual CBEs. Few women took tamoxifen or oral contraceptive pills or had a bilateral salpingo-oophorectomy or bilateral mastectomy for cancer risk reduction. Twelve percent likely had unnecessary ovarian cancer screening. About 35% used other means, including herbs and homeopathy, for cancer prevention.
  
  
  CONCLUSIONS
  Nearly a third of the affected women had not had appropriate breast cancer screening. About 12% used unsubstantiated, potentially harmful cancer "prevention" measures (e.g., herbs).
  
  
  CONCLUSIONS
  Nurses should assess clients' personal and family breast and ovarian cancer histories and promote cancer screening and risk-reducing behaviors that are appropriate for age and risk level.
authors.affiliation: Clinical Cancer Genetics Department, City of Hope Cancer Center, Duarte, CA, USA. dmacdonald@coh.org
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: MacDonald
authors.forename: Linda
authors.initials: L
authors.lastname: Sarna
authors.forename: Gwen C
authors.initials: GC
authors.lastname: Uman
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Weitzel
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics* / Q000517:prevention & control*; D018394:CA-125 Antigen / Q000097:blood; D002140:California / Q000453:epidemiology; D000529:Complementary Therapies / Q000706:statistics & numerical data; D003276:Contraceptives, Oral / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data*; D008408:Mastectomy / Q000706:statistics & numerical data; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics* / Q000517:prevention & control*; D010052:Ovariectomy / Q000706:statistics & numerical data; D011446:Prospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data; D040242:Risk Reduction Behavior; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D014463:Ultrasonography / Q000706:statistics & numerical data
chemical_list: D018394:CA-125 Antigen; D003276:Contraceptives, Oral; D020845:Selective Estrogen Receptor Modulators