Understanding measures of risk in women with family histories of breast cancer

Abstract

Perception of risk is a construct used by researchers in health and risk literature, but is not well understood. Researchers measure perception of risk in different formats, yet have not adequately assessed the impact of question style on the outcome. Empirical studies have shown that women under and overestimate their perceived risks of breast cancer. Yet few studies examine the construct of risk perception, and what factors moderate the responses given to questions of perceived risk. Furthermore, studies have shown that women with greater objective risk have higher levels of distress, but have not examined the mediating influence of perceived risk on distress. This study examines multiple measures of perceived risk and objective risk in women with various histories of breast cancer and analyzes the relationship between objective risk and perceived risk, as well as identifying moderators of perceived risk. Finally the study explores the question of perceived risk as a mediator of acute distress.;A sample of 181women (FH+ = 60, FH- = 121) was recruited from major medical centers in New York. Participants completed demographic questionnaires, three perceived risk questions, a mix of cognitive and emotional surveys that identify possible moderators of perceived risk and answered acute distress measures over three study visits one month apart.;Primary research questions addressed (1) the relationship between perceived risk measures, objective risk measures and each other (2) how objective risk measures predict perceived risk measures; (3) what moderates different measures of perceived risk and (4) how perceived risk mediates the relationship between objective risk and acute distress.;Data analysis revealed that perceived risk and objective risk are related and predictive of perceived risk. However moderators of the relationship between family history and perceived risk exist and include a mix of cognitive, emotional and cancer knowledge and experience factors and interact with family history grouping. Also, perceived risk mediates the relationship of family history and acute distress, in some cases almost completely. Perceived risk measures deserve yet more attention from researchers both in how the questions are worded, what are its determinants, and the impact of perceived risk on acute distress.