title: Underestimation of breast cancer risk: influence on screening behavior.
abstract: OBJECTIVE
  To describe perceived breast cancer risk, identify the percentage of women with inaccurate risk perceptions, and examine the influence of perceived and objective risk on screening behavior.
  
  
  METHODS
  Descriptive, correlational, cross-sectional.
  
  
  METHODS
  Community settings in a metropolitan area on the western coast of the United States.
  
  
  METHODS
  Multicultural sample of 184 English-speaking women (57% non-Caucasian, X age = 47 +/- 12 years) who have never been diagnosed with cancer.
  
  
  METHODS
  Two perceived risk scales (verbal and comparative) and the Gail model were used to assess perceived and objective breast cancer risk, respectively.
  
  
  METHODS
  Perceived breast cancer risk, objective breast cancer risk, screening behavior.
  
  
  RESULTS
  Participants reported that they "probably will not" get breast cancer and that their risk was "somewhat lower" than average. Family history of breast cancer was a significant predictor of perceived risk. Demographic characteristics and objective risk factors were not associated with perceived risk. Most women at high risk for breast cancer (89%) underestimated their actual risk; fewer women with low to average risk for breast cancer (9%) overestimated their risk. Age, Gail scores, and health insurance status promoted breast cancer screening; underestimation of risk had the opposite effect.
  
  
  CONCLUSIONS
  Inaccurate perceptions of risk do not promote optimal breast cancer screening. The finding has implications for most women at high risk for developing breast cancer who underestimate their risk.
  
  
  CONCLUSIONS
  Oncology nurses can use risk assessment tools to provide individualized counseling regarding breast cancer risk factors and screening. Women at high risk who underestimate their risk could benefit from additional screening and from advances in cancer chemoprevention.
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, USA. mkatapo@umich.edu
authors.forename: Maria C
authors.initials: MC
authors.lastname: Katapodi
authors.forename: Marylin J
authors.initials: MJ
authors.lastname: Dodd
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Lee
authors.forename: Noreen C
authors.initials: NC
authors.lastname: Facione
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000451:nursing* / Q000523:psychology*; D008875:Middle Aged; D009859:Oncology Nursing; D010349:Patient Compliance / Q000523:psychology; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012309:Risk-Taking