Abstract
This study applied the self-regulation model to examine cognitive and emotional predictors of screening in unaffected women with a strong family history of breast cancer. 748 unaffected female members of an Australian registry of multiple-case breast cancer families formed the sample. Participants completed a baseline psychosocial questionnaire and a screening questionnaire 3 years later. Multinomial logistic regression was employed to determine predictors of under- and over-screening according to national guidelines. At follow-up 16% of women under-screened and 10% over-screened with mammography; 55% under-screened with clinical breast examination (CBE); and 9% over-screened with breast self-examination (BSE). Of the women found screening according to guidelines for mammography 72% reported ever having received specific recommendations for mammography screening from a health professional. Compared to appropriate screeners, under-screeners on mammography were less likely to have received a screening recommendation (as were under-screeners on CBE), were younger and reported lower perceived breast cancer risk, but were at higher relative risk (RR) of breast cancer and were more likely to report elevated depression. Over-screeners on mammography were more likely to be younger and have a lower RR of breast cancer. Over-screeners on BSE reported elevated cancer-specific anxiety, were less likely to be university educated and more likely to have received a recommendation for BSE. Under- and over-screening is common in women with a strong family history of breast cancer. Evaluation of interventions targeting perceived risk of breast cancer, anxiety and depression are needed to ensure women obtain accurate advice from relevant specialists and enact screening recommendations.
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Acknowledgments
We are very grateful to the many families who contribute to kConFab. We also wish to thank Heather Thorne, Eveline Niedermayr, all the kConFab research nurses and staff, kConFab is supported by grants from the National Breast Cancer Foundation, the NHMRC, the Queensland Cancer Fund, the Cancer Councils of New South Wales, Victoria, Tasmania and South Australia, and the Cancer Foundation of Western Australia. This study was funded by National Health and Medical Research Council (NHMRC) Project Grants No. 153824, 301930, 145684, 288704, and 454508. P Butow receives a Principal Research Fellowship from NHMRC, B Meiser receives a Career Development Award from the NHMRC, and K-A Phillips is the John Colebatch Clinical Research Fellow of the Cancer Council Victoria.
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This study is conducted on behalf of the kConFab Investigators.
The list of authors included in these groups are listed in Appendix.
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The kConFab Psychosocial group includes the following in addition to the authors listed in the author group: Department of Medical Oncology, Prince of Wales Hospital, Randwick, Australia (B Bennett, K Tucker); Northern Sydney and Central Coast Area Health Service, Sydney, Australia (C Tennant). The kConFab Clinical Follow-Up group includes the following in addition to authors listed in the author group: Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Victoria, Australia (JL Hopper, MA Jenkins), Department of Hematology and Medical Oncology, Peter MacCallum Cancer Centre, Victoria, Australia (P Weideman, L Burnham, K Lucas), Department of Medical Oncology, Prince of Wales Hospital, Randwick, Australia (ML Friedlander), Genetic and Molecular Epidemiology Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain (RL Milne), Familial Cancer Centre, Department of Medical Oncology, Royal Melbourne Hospital, Parkville, Victoria, Australia (GJ Lindeman).
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Price, M.A., Butow, P.N., Charles, M. et al. Predictors of breast cancer screening behavior in women with a strong family history of the disease. Breast Cancer Res Treat 124, 509–519 (2010). https://doi.org/10.1007/s10549-010-0868-1
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DOI: https://doi.org/10.1007/s10549-010-0868-1