title: Sociocultural predictors of breast cancer risk perceptions in African American breast cancer survivors.
abstract: Although African American breast cancer survivors are at increased risk for developing breast cancer again, empirical data are not available on breast cancer risk perceptions in these women. This study characterized perceived risk of developing breast cancer in African American breast cancer survivors at risk for having a BRCA1 or BRCA1 (BRCA1/2) mutation and identified factors having significant independent associations with risk perceptions. Participants were 95 African American breast cancer survivors at an increased risk for having a BRCA1/2 mutation. Risk perceptions and sociodemographic, clinical, treatment, and sociocultural factors were collected during a structured telephone interview. Most women reported that they had the same or lower risk of developing breast cancer again compared with other women (53%); however, a substantial minority of women (47%) reported that they had a higher or much higher risk. Factors having significant independent associations with heightened risk perceptions included having a >or=10% prior probability of having a BRCA1/2 mutation [odds ratio (OR), 2.91; 95% confidence interval (95% CI), 1.09-7.72; P = 0.03] and more years of formal education (OR, 2.74; 95% CI, 1.02-7.36; P = 0.05). In addition, women who thought about the past a lot were three times more likely to report heightened risk perceptions compared with those who did not think about the past a lot (OR, 3.72; 95% CI, 1.45-9.57; P = 0.01). These results suggest that it may be important to ensure adequate risk comprehension among African American women as part of genetic counseling for inherited breast-ovarian cancer risk. Discussion of risk perceptions within the context of existing beliefs and values may facilitate this process.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Kiyona
authors.initials: K
authors.lastname: Brewster
authors.forename: E Paul
authors.initials: EP
authors.lastname: Wileyto
authors.forename: Lisa
authors.initials: L
authors.lastname: Kessler
authors.forename: Aliya
authors.initials: A
authors.lastname: Collier
authors.forename: Benita
authors.initials: B
authors.lastname: Weathers
authors.forename: Jill E
authors.initials: JE
authors.lastname: Stopfer
authors.forename: Susan
authors.initials: S
authors.lastname: Domchek
authors.forename: Chanita Hughes
authors.initials: CH
authors.lastname: Halbert
mesh_terms: D001741:Black or African American / Q000235:genetics / Q000523:psychology*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics / Q000523:psychology*; D016009:Chi-Square Distribution; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D012307:Risk Factors; D017741:Survivors