Identifying women at risk for inherited breast cancer using a mammography registry.

BACKGROUND: Women at risk for inherited breast cancer have been identified for intervention studies through newly diagnosed relatives or from volunteers with a family history. This pilot study tested the use of a mammography registry to identify women at risk. METHOD: Fifty women with first-degree relatives diagnosed as having breast cancer before age 45 were randomly selected from the Vermont Breast Cancer Surveillance System. Thirty-three women (66%) completed a phone interview that included a three-generation family pedigree of breast and ovarian cancers. RESULTS: Fifty-one percent of the women were at higher risk for inherited breast cancer based on the family history. Eighteen percent of the first-degree relatives' breast cancers were pathologically confirmed. CONCLUSION: Mammography registries that collect similar family history data may be used to identify women at risk for inherited breast cancer. Many intervention studies would require improved methods to obtain pathologic confirmation.

Likelihood of undergoing genetic testing for cancer risk: a population-based study.

BACKGROUND: Studies on public perceptions of genetic susceptibility testing for cancer risks are few and tend to focus on specific cancer risks of higher-risk populations, ignoring the general population and their perceived risk of getting any cancers. This study develops and tests a psychosocial model of the proximal and distal influences on likelihood of undergoing genetic susceptibility testing for cancer risk among a population-based sample. METHODS: The sample consisted of 622 adults aged 18-75 interviewed by telephone. The survey instrument included measures derived from the Health Belief Model and adaptations of existing measures from the literature. Data were analyzed using structural equation modeling techniques. RESULTS: The model suggested independent main effects for perceived benefits, perceived barriers, perceived susceptibility, and pessimism while simultaneously accounting for the effects of age, socioeconomic status, family history of cancer, and awareness of the existence of genetic susceptibility testing for cancer risk. The model explained 34% of the variance in likelihood. CONCLUSIONS: While perceived benefits, perceived barriers, perceived susceptibility, and pessimism may directly impact likelihood, they may also mediate the effects of age, socioeconomic status, family history of cancer, and awareness of cancer genetic susceptibility testing, on likelihood.

Three-year prospective adherence to three breast cancer screening modalities.

BACKGROUND: This study prospectively examined rates of adherence to mammography, clinical breast examination (CBE), and breast self-examination (BSE) in a cohort of women over 3 years to determine whether participation in BSE influenced participation in the other two screening modalities. METHODS: Women ages 51 and older (n = 450) who attended a small group educational session to learn BSE and to hear about CBE and mammography guidelines were assessed annually by telephone for 3 consecutive years to determine their subsequent breast cancer screening behavior. RESULTS: Annual CBE and mammography screening are highly positively associated. Regular performance of BSE has a modest positive association with both CBE and mammography adherence over time. CONCLUSIONS: Women who perform BSE regularly over time may be more likely to adhere to the other breast cancer screening guidelines.