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    Do women understand the odds? Risk perceptions and recall of risk information in women with a family history of breast cancer.

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    Authors
    Hopwood, Penelope
    Howell, Anthony
    Lalloo, Fiona
    Evans, D Gareth R
    Affiliation
    Psycho-Oncology, Christie Hospital NHS Trust, Manchester, UK. penny.hopwood@christie-tr.nwest.nhs.uk
    Issue Date
    2003
    
    Metadata
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    Abstract
    OBJECTIVES: To describe and compare women's risk perceptions and recall of breast cancer risk information in a cohort of first-time attendees at a family history clinic. METHODS: We conducted a 1-year prospective study of 158 women aged 18-45 years with a confirmed lifetime risk of breast cancer of 1 in 6 or greater. Risk perception and recall were assessed using a self-report questionnaire, completed pre-counselling and 3, 6, 9 and 12 months post-counselling, and through interviews conducted at 3 and 12 months. RESULTS: The proportion of women with accurate personal risk perceptions based on 'gambling' odds ('1 chance in x') significantly improved after risk counselling from 12% pre-counselling to 67% 3 months post-counselling (p < 0.001), which was maintained for 1 year. This was the method of reporting perceived risk associated with the best level of risk accuracy and the women's preferred format for describing risk, but the concept of lifetime risk was understood by only 44% of women. Qualitative risk categories ('high', moderate' or 'low') correlated significantly with women's self-reported odds values, but each category comprised a wide range of women's perceived numeric risks. Describing risk as the 'likelihood of breast cancer' resulted in a broad and somewhat inaccurate reporting of risk, compared with numeric ratings made at the same time. There was an increase of up to 4-fold in the proportion of women who failed to recall their risk value over time, and women were unable to accurately put the breast cancer risk in context compared with other health threats. CONCLUSIONS: All methods of describing risk have limitations, but the results of the present study provide good support for women's accurate recall of numeric risk values and their preference for use of these 'gambling' odds. This may have been influenced by consistency of the use of this method both in risk communication and in personal summary letters. Descriptive risk formats reflected higher levels of perceived vulnerability to breast cancer, and genetic counsellors need to be aware of these different perceptions.
    Citation
    Do women understand the odds? Risk perceptions and recall of risk information in women with a family history of breast cancer. 2003, 6 (4):214-23 Community Genet
    Journal
    Community Genetics
    URI
    http://hdl.handle.net/10541/78903
    DOI
    10.1159/000079383
    PubMed ID
    15331867
    Type
    Article
    Language
    en
    ISSN
    1422-2795
    ae974a485f413a2113503eed53cd6c53
    10.1159/000079383
    Scopus Count
    Collections
    All Christie Publications

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