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dc.contributor.authorHopwood, Penelope
dc.contributor.authorHowell, Anthony
dc.contributor.authorLalloo, Fiona
dc.contributor.authorEvans, D Gareth R
dc.date.accessioned2009-08-27T14:07:26Z
dc.date.available2009-08-27T14:07:26Z
dc.date.issued2003
dc.identifier.citationDo 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 Geneten
dc.identifier.issn1422-2795
dc.identifier.pmid15331867
dc.identifier.doi10.1159/000079383
dc.identifier.urihttp://hdl.handle.net/10541/78903
dc.description.abstractOBJECTIVES: 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.
dc.language.isoenen
dc.subjectBreast Canceren
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshAttitude to Health
dc.subject.meshBreast Neoplasms
dc.subject.meshCommunication
dc.subject.meshComprehension
dc.subject.meshFemale
dc.subject.meshGenetic Counseling
dc.subject.meshGenetic Predisposition to Disease
dc.subject.meshHumans
dc.subject.meshMental Recall
dc.subject.meshMiddle Aged
dc.subject.meshPatient Education as Topic
dc.subject.meshPatient Satisfaction
dc.subject.meshRisk Factors
dc.titleDo women understand the odds? Risk perceptions and recall of risk information in women with a family history of breast cancer.en
dc.typeArticleen
dc.contributor.departmentPsycho-Oncology, Christie Hospital NHS Trust, Manchester, UK. penny.hopwood@christie-tr.nwest.nhs.uken
dc.identifier.journalCommunity Geneticsen
html.description.abstractOBJECTIVES: 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.


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