Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population

Abstract

Objective Worry about developing breast cancer (BC worry) has been associated with participation in screening and genetic testing and with follow-up of abnormal screening results. Little is known about the scope and predictors of BC worry in Hispanic and immigrant populations. Methods We collected in-person interview data from 250 self-identified Hispanic women recruited from an urban mammography facility (average age 50.4 years; 82% foreign-born). Women reported whether they worried about developing breast cancer rarely/never (low worry), sometimes (moderate worry) or often/all the time (high worry). We examined whether sociocultural and psychological factors (e.g., acculturation, education, perceived risk), and risk factors and objective risk for breast cancer (e.g., family history, Gail model 5-year risk estimates, parity) predicted BC worry using multinomial and binary logistic regression. Results In multivariable models, women who perceived higher absolute breast cancer risk (OR=1.66, 95% CI: 1.28, 2.14 for one unit increase in perceived lifetime risk) and comparative breast cancer risk (e.g., OR=2.37, 95% CI: 1.23, 6.06) were more likely to report high BC worry than moderate or low BC worry. There were no associations between BC worry and indicators of objective risk or acculturation. Conclusions In Hispanic women undergoing screening mammography, higher perceptions of breast cancer risk, on both absolute and comparative terms, were independently associated with high BC worry, and were stronger predictors of BC worry than indicators of objective breast cancer risk, including family history, mammographic density and personal breast cancer risk estimates.

“You probably can’t feel as safe as normal women”: Hispanic women’s reactions to breast density notification

“…These findings may not reflect women’s experiences at smaller community clinics or in rural areas. In addition, we previously reported a high level of breast cancer worry in the catchment community of the current study, which included regularly screened women with pro‐screening attitudes. Thus, the current study results, particularly in terms of interest in following a more intensive breast cancer screening, may not describe the full breadth of women’s perspectives, including those of women with a more limited screening history.…”

“…Participants were drawn from a sample of women who were enrolled into an ongoing observational study from a large screening mammography clinic in New York City. Of this study sample, 41 women met the eligibility criteria of self‐identifying as Hispanic and having a history of dense breasts since the enactment of NYS notification legislation, defined according to the BDN legislation (BI‐RADS density categories c and d) . Participant characteristics and risk factors were assessed at the time of enrollment (2012‐2014), which occurred on average 2.5 years prior to the qualitative interviews in the current study.…”

Childhood body size and midlife mammographic breast density in foreign-born and U.S.-born women in New York City

“…We used data from the first two waves of the New York Mammographic Density Study, an ongoing study of breast cancer screening and prevention in women, recruited during screening mammography visits at a community clinic in New York City (24,25); women presenting for diagnostic mammograms attended a different mammography site. We followed the same standard protocol for recruitment and data collection in both study waves, yielding a study sample representative of the racial/ethnic and sociodemographic distribution of the community, although our sample had a higher proportion of foreign-born women than in the community due to the older age range in our sample (26).…”

Evaluating the Harms of Cancer Testing—A Systematic Review of the Adverse Psychological Correlates of Testing for Cancer and the Effectiveness of Interventions to Mitigate These

“…Two SRs (including seven studies [ 16 ] and seven studies [ 19 ] each) and three cross-sectional studies found a negative association between age and psychosocial morbidity in screening for breast [ 22 , 23 ], pancreatic [ 16 ], cervical [ 29 ], and colorectal [ 19 ] cancers.…”