Adherence to mammography among subgroups of women at high risk for breast cancer
We present analyses comparing risk perception and screening behavior within subgroups of women at increased risk for breast cancer by virtue of family history and other epidemiologic risk factors. Subjects included 967 women over 35 years of age who were first-degree relatives of index breast cancer patients. The sample was categorized three different ways to represent those with the different degrees of risk: (1) women with one vs. two or more first-degree relatives with diagnosed breast cancer, (2) women with at least one relative diagnosed with breast cancer at an early age (<45 years) and (3) women classified according to quartiles of relative risk (RR) for breast cancer as calculated by the Gail et al. model. Logistic regression models were fit to predict adherence to mammography. There were no differences in perception of risk for breast cancer within each of the three risk categories of women. Results of the multivariate analyses demonstrated that women with two or more first-degree relatives were over twice as likely to adhere to mammography screening as women with one affected first-degree relative. Women classified in the fourth quartile of RR (i.e., at highest risk) for breast cancer also were over two times more likely to be mammography adherers compared with women in the first quartile (i.e., at lowest risk). Age at diagnosis of the relative's breast cancer was not predictive of screening behavior. In this sample, family history and other personal risk factors influenced breast cancer screening participation. This information can be used to refine educational interventions for family members of breast cancer patients. There is a particular need for physicians to inform women about the importance of early age of diagnosis as a risk factor for breast cancer.
