Relationships among Breast Cancer Perceived Absolute Risk, Comparative Risk, and Worries

Relationships among Breast Cancer Perceived Absolute Risk, Comparative Risk, and Worries1

Duke University Medical Center, Durham, North Carolina 27701 [I. M. L., M. K., C. M. M., H. B. B., K. I. P., I. C. S.], and National Cancer Institute, Bethesda, Maryland 20892 [B. K. R.]

Abstract

When trying to predict breast cancer screening, it may be important to understand the relationships between perceived breast cancer risks and worries about getting breast cancer. This study examines the extent to which women’s worries about breast cancer correlate with perceptions of both absolute (assessment of own) and comparative (self versus other) 10-year and lifetime risks. As part of a larger randomized intervention trial concerning hormone replacement therapy, 581 women participated in a telephone baseline survey to assess their perceptions of breast cancer risks and worries. Worries about getting breast cancer in the next 10 years and in one’s lifetime were related positively to both absolute and comparative 10-year and lifetime risks. The magnitude of these relationships did not differ by time frame. Worry about breast cancer is a function of both how a woman views her own risk and how she compares her risk with that of other women. Some practitioners may encourage women to get screened for breast cancer by using emotional appeals, such as heightening women’s worries about breast cancer by using risk information. Our data suggest that they should give careful consideration how best to combine, if at all, information about absolute and comparative risks. For example, if the motivation to screen is based on a sequential assessment of risk beginning with comparative and then absolute risk, creating communications that heighten perceived risk on both of these risk dimensions may be needed to evoke sufficient worry to initiate breast cancer screening.

Footnotes

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↵1 Supported by the National Cancer Institute Grant 5U19CA72099-04.
↵2 To whom requests for reprints should be addressed, at Duke University Medical Center, 905 West Main Street, Box 34, South Building, Durham, NC 27701. E-mail: Lipku001{at}mc.duke.edu
↵3 A possible exception to the general statement that breast cancer worries and comparative risks have not been examined together is the study by McCaul and O’Donnell (5) . They assessed the relationship between absolute and comparative risks with the intrusion subscale of the Revised Impact of Events Scale (13) as a measure of breast cancer worry. Both risk estimates were related to more intrusive thoughts (rs = 0.34 and 0.38 for the absolute and comparative risk measures, respectively, ps < 0.01). For purposes of this study, it is questionable whether the Revised Impact of Events Scale should be considered a direct measure of the magnitude of breast cancer worries rather than a general measure of psychological distress.
↵4 We assessed partial correlations among the verbal anchors rather than verbal and numerical anchored responses to keep the scaling of the outcomes (i.e., verbal) consistent.
- Accepted June 15, 2000.
- Received December 30, 1999.
- Revision received June 6, 2000.