title: Perceived risk of breast cancer among Latinas attending community clinics: risk comprehension and relationship with mammography adherence.
abstract: OBJECTIVE
  To describe breast cancer risk perceptions, determine risk comprehension, and evaluate mammography adherence among Latinas.
  
  
  METHODS
  Latina women age >or=35, primarily from Central and South America, were recruited from community-based clinics to complete in-person interviews (n = 450). Risk comprehension was calculated as the difference between numeric perceived risk and Gail risk score. Based on recommended guidelines from the year data were collected (2002), mammography adherence was defined as having a mammogram every one to two years for women >or=40 years of age.
  
  
  RESULTS
  Breast cancer risk comprehension was low, as 81% of women overestimated their risk and only 6.9% of women were high risk based on Gail risk scores. Greater cancer worry and younger age were significantly associated with greater perceived risk and risk overestimation. Of women age eligible for mammography (n = 328), 29.0% were non-adherent to screening guidelines. Adherence was associated with older age, (OR = 2.99, 95% CI = 1.76-5.09), having insurance (OR = 1.81, 95% CI = 1.03-3.17), greater acculturation (OR = 1.18, 95% CI = 1.02-1.36), and higher breast cancer knowledge (OR = 2.03, 95% CI = 1.21-3.40).
  
  
  CONCLUSIONS
  While most Latinas over-estimated their breast cancer risk, older age, having insurance, being more acculturated, and having greater knowledge were associated with greater screening adherence in this Latino population. Perceived risk, risk comprehension, and cancer worry were not associated with adherence. In Latinas, screening interventions should emphasize knowledge and target education efforts at younger, uninsured, and less acculturated mammography-eligible women.
authors.affiliation: Department of Oncology, Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20007, USA, kdg9@georgetown.edu
authors.forename: Kristi D
authors.initials: KD
authors.lastname: Graves
authors.forename: Elmer
authors.initials: E
authors.lastname: Huerta
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cullen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kaufman
authors.forename: Vanessa
authors.initials: V
authors.lastname: Sheppard
authors.forename: George
authors.initials: G
authors.lastname: Luta
authors.forename: Claudine
authors.initials: C
authors.lastname: Isaacs
authors.forename: Marc D
authors.initials: MD
authors.lastname: Schwartz
authors.forename: Jeanne
authors.initials: J
authors.lastname: Mandelblatt
mesh_terms: D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D003151:Community Health Centers; D032882:Comprehension; D016001:Confidence Intervals; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012959:Socioeconomic Factors