Family history of breast cancer and screening behavior: an inverted U-shaped curve?

There are conflicting reports regarding the association between breast cancer risk factors, especially family history, and early detection/screening behavior. While some studies have reported that women at higher risk for breast cancer engage in more screening behavior than those at lower risk, others have found no relationship between the two variables, and still other studies have found the opposite effect--less screening in high risk women as compared to lower risk women. It is suggested that these conflicting results might be explained by including anxiety or fear as a mediating factor in the relationship between risk status and screening behavior. Specifically, it is hypothesized that anxiety or fear associated with family history of breast cancer operates in a manner similar to that observed in other behavioral tasks. That is, an optimal amount of anxiety or fear facilitates performance, but too much inhibits it. Previous studies are examined in the context of this hypothesis.