title: Does perceived risk predict breast cancer screening use? Findings from a prospective cohort study of female relatives from the Ontario site of the breast cancer family registry.
abstract: While the relationship between perceived risk and breast cancer screening use has been studied extensively, most studies are cross-sectional. We prospectively examined this relationship among 913 women, aged 25-72 with varying levels of familial breast cancer risk from the Ontario site of the Breast Cancer Family Registry. Associations between perceived lifetime breast cancer risk and subsequent use of mammography, clinical breast examination (CBE) and genetic testing were assessed using logistic regression. Overall, perceived risk did not predict subsequent use of mammography, CBE or genetic testing. Among women at moderate/high familial risk, those reporting a perceived risk greater than 50% were significantly less likely to have a CBE (odds ratio (OR) = 0.52, 95% confidence interval (CI): 0.30-0.91, p = 0.04), and non-significantly less likely to have a mammogram (OR = 0.70, 95% CI: 0.40-1.20, p = 0.70) or genetic test (OR = 0.61, 95% CI: 0.34-1.10, p = 0.09) compared to women reporting a perceived risk of 50%. In contrast, among women at low familial risk, those reporting a perceived risk greater than 50% were non-significantly more likely to have a mammogram (OR = 1.13, 95% CI: 0.59-2.16, p = 0.78), CBE (OR = 1.11, 95% CI: 0.63-1.95, p = 0.74) or genetic test (OR = 1.29, 95% CI: 0.50-3.33, p = 0.35) compared to women reporting a perceived risk of 50%. Perceived risk did not significantly predict screening use overall, however this relationship may be moderated by level of familial risk. Results may inform risk education and management strategies for women with varying levels of familial breast cancer risk.
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: meghan.walker@cancercare.on.ca.
authors.forename: Meghan J
authors.initials: MJ
authors.lastname: Walker
authors.affiliation: Division of Biostatistics, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Lucia
authors.initials: L
authors.lastname: Mirea
authors.affiliation: Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Gord
authors.initials: G
authors.lastname: Glendon
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada; Faculty of Health, School of Kinesiology and Health Science, York University, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Ritvo
authors.affiliation: Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Irene L
authors.initials: IL
authors.lastname: Andrulis
authors.affiliation: Division of Epidemiology, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Knight
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Chiarelli
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009864:Ontario; D010465:Perception; D011446:Prospective Studies; D012042:Registries; D012306:Risk
keywords: Breast cancer; Breast cancer screening; Familial risk; Perceived risk