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Willingness to use tamoxifen to prevent breast cancer among diverse women

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Use of chemoprevention to prevent development of breast cancer among high-risk women has been limited despite clinical evidence of its benefit. Our goals were to determine whether knowledge of the benefits and risks of tamoxifen affects a woman’s willingness to take it to prevent breast cancer, to define factors associated with willingness to take tamoxifen, and to evaluate race/ethnic differences. Women, ages 50–80, who identified as African American, Asian, Latina, or White, and who had at least one visit to a primary care physician in the previous 2 years, were recruited from ambulatory practices. After a screening telephone survey, women completed an in-person interview in their preferred language. Multivariate regression models were constructed to examine the associations of demographic characteristics, numeracy, breast cancer history, and health knowledge with willingness to take tamoxifen. Over 40% of the women reported they would likely take tamoxifen if determined to be at high risk, and 31% would be somewhat likely to do so. Asian women, those with no insurance, and those with less than high school education were significantly more likely to be willing to take tamoxifen. Higher scores on numeracy and on breast cancer knowledge were also associated with willingness to take tamoxifen. A higher tamoxifen knowledge score was inversely related to willingness to take the drug. Factors affecting women’s willingness to take breast cancer chemoprevention drugs vary and are not determined solely by knowledge of risk/benefit or risk perception.

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Acknowledgment

This study was supported by the Agency for Healthcare Research and Quality (5P01 HS10856) for an Excellence Center to Eliminate Ethnic/Racial Disparities (EXCEED) and by Grant P30-AG15272 under the Resource Centers for Minority Aging Research program by the National Institute on Aging, National Institutes of Health and by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131.

Conflict of interest

None of the authors have any conflict of interest.

Author information

Authors and Affiliations

  1. Division of General Internal Medicine, Department of Medicine, University of California San Francisco, 3333 California Street, San Francisco, CA, 94143-0856, USA

    Celia Patricia Kaplan, Judith M. E. Walsh & Eliseo J. Pérez-Stable

  2. Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, San Francisco, CA, USA

    Celia Patricia Kaplan, George F. Sawaya & Eliseo J. Pérez-Stable

  3. Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA

    Celia Patricia Kaplan & Eliseo J. Pérez-Stable

  4. Health and Barriers to Employment, Manpower Demonstration Research Corporation (MDRC), Oakland, CA, USA

    Sue E. Kim

  5. Culture, Gender, and Health Unit, School of Nursing, Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada

    Sabrina T. Wong

  6. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA

    George F. Sawaya

  7. Women’s Health Clinical Research Center, University of California San Francisco, San Francisco, CA, USA

    Judith M. E. Walsh

Authors
  1. Celia Patricia Kaplan
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  2. Sue E. Kim
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  3. Sabrina T. Wong
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  4. George F. Sawaya
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  5. Judith M. E. Walsh
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  6. Eliseo J. Pérez-Stable
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Corresponding author

Correspondence to Eliseo J. Pérez-Stable.

Appendices

Appendix A

These next set of questions are about how people might use numbers to think about their health. These questions are not to test you or make you feel that you must give me the right answer. I am not interested in whether you know the right or wrong answer. These questions will be used to help doctors communicate better with their patients about medical information that involves numbers.

Appendix B

Knowledge of breast cancer and tamoxifen

I’m going to read you some statements about breast cancer and tamoxifen. 

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Kaplan, C.P., Kim, S.E., Wong, S.T. et al. Willingness to use tamoxifen to prevent breast cancer among diverse women. Breast Cancer Res Treat 133, 357–366 (2012). https://doi.org/10.1007/s10549-012-1960-5

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  • DOI: https://doi.org/10.1007/s10549-012-1960-5

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