Summary
Objective
While the relationship between perceived risk and adherence to breast cancer screening guidelines has been studied extensively, the majority of studies are cross-sectional. We prospectively examined this relationship among women with familial risk.
Materials and Methods
The prospective association between perceived risk and screening behaviors was examined in 913 women aged 25 to 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 screening mammography, clinical breast examination (CBE) and genetic testing were assessed using logistic regression.
Results
Overall, perceived risk did not predict subsequent use of screening mammography, CBE or genetic testing. Women at moderate/high familial risk who perceived their risk as 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 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 who perceive their risk as 50%. In contrast, women at low familial risk who perceived their risk as 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 who perceive their risk as 50%.
Conclusion
Perceived risk did not significantly predict subsequent screening use overall, however this relationship may be moderated by level of familial risk. Results may inform risk education and management strategies among women with varying levels of familial breast cancer risk.