Zhuoer Xie1, Neil Wenger2, Annette L Stanton3, Karen Sepucha4, Celia Kaplan5, Lisa Madlensky6, David Elashoff7, Jacqueline Trent1, Antonia Petruse1, Liliana Johansen1, Tracy Layton8, Arash Naeim9. 1. Department of Hematology and Oncology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California. 2. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California. 3. Department of Psychology, University of California, Los Angeles, Los Angeles, California. 4. Health Decision Sciences Center, Massachusetts General Hospital, Boston, Massachusetts. 5. General Internal Medicine, University of California, San Francisco, San Francisco, California. 6. Division of Medical Genetics, University of California, San Diego, San Diego, California. 7. Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California. 8. Department of Biomedical Informatics, University of California, San Diego, San Diego, California. 9. UCLA Center for SMART Health, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Abstract
OBJECTIVE: Elevated anxiety and breast cancer worry can impede mammographic screening and early breast cancer detection. Genetic advances and risk models make personalized breast cancer risk assessment and communication feasible, but it is unknown whether such communication of risk affects anxiety and disease-specific worry. We studied the effect of a personalized breast cancer screening intervention on risk perception, anxiety, and breast cancer worry. METHODS: Women with a normal mammogram but elevated risk for breast cancer (N = 122) enrolled in the Athena Breast Health risk communication program were surveyed before and after receiving a letter conveying their breast cancer risk and a breast health genetic counselor consultation. We compared breast cancer risk estimation, anxiety, and breast cancer worry before and after risk communication and evaluated the relationship of anxiety and breast cancer worry to risk estimation accuracy. RESULTS: Women substantially overestimated their lifetime breast cancer risk, and risk communication somewhat mitigated this overestimation (49% pre-intervention, 42% post-intervention, 13% Gail model risk estimate, P < .001). Both general anxiety and breast cancer worry declined significantly after risk communication in women with high baseline anxiety. Baseline anxiety and breast cancer worry were essentially unrelated to risk estimation accuracy, but risk communication increased alignment of worry with accuracy of risk assessment. CONCLUSIONS: Personalized communication about breast cancer risk was associated with modestly improved risk estimation accuracy in women with relatively low anxiety and less anxiety and breast cancer worry in women with higher anxiety. We detected no negative consequences of informing women about elevated breast cancer risk.
OBJECTIVE: Elevated anxiety and breast cancer worry can impede mammographic screening and early breast cancer detection. Genetic advances and risk models make personalized breast cancer risk assessment and communication feasible, but it is unknown whether such communication of risk affects anxiety and disease-specific worry. We studied the effect of a personalized breast cancer screening intervention on risk perception, anxiety, and breast cancer worry. METHODS:Women with a normal mammogram but elevated risk for breast cancer (N = 122) enrolled in the Athena Breast Health risk communication program were surveyed before and after receiving a letter conveying their breast cancer risk and a breast health genetic counselor consultation. We compared breast cancer risk estimation, anxiety, and breast cancer worry before and after risk communication and evaluated the relationship of anxiety and breast cancer worry to risk estimation accuracy. RESULTS:Women substantially overestimated their lifetime breast cancer risk, and risk communication somewhat mitigated this overestimation (49% pre-intervention, 42% post-intervention, 13% Gail model risk estimate, P < .001). Both general anxiety and breast cancer worry declined significantly after risk communication in women with high baseline anxiety. Baseline anxiety and breast cancer worry were essentially unrelated to risk estimation accuracy, but risk communication increased alignment of worry with accuracy of risk assessment. CONCLUSIONS: Personalized communication about breast cancer risk was associated with modestly improved risk estimation accuracy in women with relatively low anxiety and less anxiety and breast cancer worry in women with higher anxiety. We detected no negative consequences of informing women about elevated breast cancer risk.
Authors: Sarah L Elson; Robert A Hiatt; Hoda Anton-Culver; Lydia P Howell; Arash Naeim; Barbara A Parker; Laura J Van't Veer; Michael Hogarth; John P Pierce; Robert J Duwors; Kathy Hajopoulos; Laura J Esserman Journal: Breast Cancer Res Treat Date: 2013-07-26 Impact factor: 4.872
Authors: M H Gail; L A Brinton; D P Byar; D K Corle; S B Green; C Schairer; J J Mulvihill Journal: J Natl Cancer Inst Date: 1989-12-20 Impact factor: 13.506
Authors: S G Zakowski; H B Valdimarsdottir; D H Bovbjerg; P Borgen; J Holland; K Kash; D Miller; J Mitnick; M Osborne; K Van Zee Journal: Ann Behav Med Date: 1997
Authors: Phyllis N Butow; Elizabeth A Lobb; Bettina Meiser; Alexandra Barratt; Katherine M Tucker Journal: Med J Aust Date: 2003-01-20 Impact factor: 7.738
Authors: Claire C Conley; Karen J Wernli; Sarah Knerr; Tengfei Li; Kathleen Leppig; Kelly Ehrlich; David Farrell; Hongyuan Gao; Erin J A Bowles; Amanda L Graham; George Luta; Jinani Jayasekera; Jeanne S Mandelblatt; Marc D Schwartz; Suzanne C O'Neill Journal: J Cancer Educ Date: 2021-11-23 Impact factor: 1.771
Authors: Carly A Conran; Zhuqing Shi; William Kyle Resurreccion; Rong Na; Brian T Helfand; Elena Genova; Siqun Lilly Zheng; Charles B Brendler; Jianfeng Xu Journal: J Transl Med Date: 2021-01-22 Impact factor: 5.531
Authors: Maria Papaleontiou; Bradley Zebrack; David Reyes-Gastelum; Andrew J Rosko; Sarah T Hawley; Ann S Hamilton; Kevin C Ward; Megan R Haymart Journal: J Cancer Surviv Date: 2020-09-16 Impact factor: 4.062