Abstract P4-13-05: The gap between perceptions of risk and actual risk for breast cancer.
Authors: Kaplan CP , Lopez M , Tice J , Pasick R , Kerlikowske K , Chen A , Karliner L 
Published: August 2014

Background: Estimating a woman's individual risk for breast cancer is essential for tailoring appropriate screening and risk reduction strategies. Prior research suggests that women often misperceive their risk as either higher or lower than it actually is. As a result, average risk women who perceive their risk to be high may experience unnecessary anxiety. In contrast, high risk women who perceive their risk to be average/low may not utilize needed screening or available risk reduction options. The overall aim of this study is to compare perception of breast cancer risk to actual risk among a sample of multi-ethnic women with a range of breast cancer risk.

Methods: As part of BREASTCARE, a randomized controlled trial designed to evaluate a PC-tablet based intervention providing multi-ethnic women and their primary care physicians with tailored information about breast cancer risk, we collected baseline information regarding perception of risk. Women visiting general internal medicine primary care clinics at two sites (one academic practice and one safety net practice) during the study period, between the ages of 40 and 74, who spoke English, Spanish or Chinese, and had no personal history of breast cancer were eligible to participate. Participants were asked how concerned they were about getting breast cancer: very concerned, somewhat concerned, a little concerned, or not at all concerned. They were also asked what they believed their chances of getting breast cancer were compared to other women their age: higher, the same, or lower. We classified women as high risk if they had a positive family history based on the Referral Screening Tool (Bellcross, et al. 2009), or were in the top 5% estimated 5-year risk for their age group based on either the Gail Model (Gail et al. 1999) or the Breast Cancer Surveillance Consortium Model when breast density data was available (Tice et al. 2008). We then compared women's perception of breast cancer risk with their actual risk.

Results: To date, data has been obtained for 913 participants. One third of the women were white, 23% Black, 23% Latina and 17% Asian. Twenty percent (N = 182) of the women were classified as high risk. Among average risk women (N = 727) 48% were very or somewhat concerned about getting breast cancer. In contrast, 35% of high risk women were a little or not at all concerned. When asked how their chances of getting breast cancer compared to other women their age, 20% of average risk women thought their risk was higher than other women their age, while 71% of those at high risk indicated that they had the same or lower risk than other women their age.

Conclusions: Our results suggest that both average and high risk women have an incorrect perception of their personal breast cancer risk compared to their actual risk. Interventions that address this misunderstanding can help those at high risk to initiate appropriate risk reduction practices and those at average risk to reduce unnecessary anxiety.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-13-05.