Awareness of Breast Density and Its Impact on Breast Cancer Detection and Risk

Abstract

Purpose Legislation mandating disclosure of breast density (BD) information has passed in 21 states; however, actual awareness of BD and knowledge of its impact on breast cancer detection and risk are unknown. Methods We conducted a national cross-sectional survey administered in English and Spanish using a probability-based sample of screening-age women, with oversampling of Connecticut, the only state with BD legislation in effect for > 1 year before the survey. Results Of 2,311 women surveyed, 65% responded. Overall, 58% of women had heard of BD, 49% knew that BD affects breast cancer detection, and 53% knew that BD affects cancer risk. After multivariable adjustment, increased BD awareness was associated with white non-Hispanic race/ethnicity (Hispanic v white non-Hispanic: odds ratio [OR], 0.23; P < .001), household income (OR, 1.07 per category increase; P < .001), education (OR, 1.19 per category increase; P < .001), diagnostic evaluation after a mammogram (OR, 2.64; P < .001), and postmenopausal hormone therapy (OR, 1.69; P = .002). Knowledge of the masking effect of BD was associated with higher household income (OR, 1.10; P < .001), education (OR, 1.22; P = .01), prior breast biopsy (OR, 2.16; P < .001), and residing in Connecticut (Connecticut v other states: OR, 3.82; P = .003). Connecticut residents were also more likely to have discussed their BD with a health care provider (67% v 43% for residents of other US states; P = .001). Conclusion Disparities in BD awareness and knowledge exist by race/ethnicity, education, and income. BD legislation seems to be effective in increasing knowledge of BD impact on breast cancer detection. These findings support continued and targeted efforts to improve BD awareness and knowledge among women eligible for screening mammography.

Visited a vape shop? Prevalence and correlates from a national sample of U.S. young adults

“…These findings may highlight a role for vape shops in intervention with multiple tobacco product use (poly-use) or poly-substance use, as previously has been done for smoking cessation [16][17][18][19][20][21][22][23][24][25][26][27] . Some vape shops also could be selling products for use in the emerging legal marijuana market 28 .…”

“…GfK provided internet access and netbooks to households that lacked them to reduce response bias. This methodology has been reported previously, 18,19 and is used broadly in peer-reviewed literature [20][21][22][23] . The baseline survey (Wave 1; n=4,215) was conducted in July 2011, with subsequent assessments occurring approximately every 6 months; the study is ongoing.…”

“…With regard to other substance use, past 30-day other drug and marijuana use were both associated with higher odds of vape shop visits, conforming to the common liability model [13][14][15][16][17][18][19][20][21][22][23][24][25][26] . These findings may highlight a role for vape shops in intervention with multiple tobacco product use (poly-use) or poly-substance use, as previously has been done for smoking cessation [16][17][18][19][20][21][22][23][24][25][26][27] .…”

“…One study noted an increase in lifetime e-cigarette use in young adults (aged 18-24) since 2010, 8 but another showed that ever e-cigarette use remained stable in this age group 9 . A recent national study found that young adults (18)(19)(20)(21)(22)(23)(24) were more likely to be some day or every day e-cigarette users than were adults over age 45. 7 Young adult past 30-day e-cigarette users compared with those with no past-month use have also reported higher prevalence of marijuana use (some days or ever day 10 or in the past 12 months 11 ), some days or every day alcohol use, 10 past 30-day binge drinking, 11 and past 30-day other tobacco (defined as use of cigars, pipes, chewing tobacco, snuff, snus, hookah, clove cigarettes, bidis, or other) product use 11 .…”

“…Since vape shops predominantly sell ENDS, we might expect their customers to be similar to ENDS users. In a 2014 national sample of adults, ever use of e-cigarettes was correlated with daily cigarette smoking, White race, younger age (age [18][19][20][21][22][23][24], and living in the Western U.S 7 . One study noted an increase in lifetime e-cigarette use in young adults (aged 18-24) since 2010, 8 but another showed that ever e-cigarette use remained stable in this age group 9 .…”