Cancer Causes & Control

, Volume 25, Issue 7, pp 771–785 | Cite as

What causes breast cancer? A systematic review of causal attributions among breast cancer survivors and how these compare to expert-endorsed risk factors

  • Jo Anne Dumalaon-CanariaEmail author
  • Amanda D. HutchinsonEmail author
  • Ivanka Prichard
  • Carlene Wilson



The aim of this paper was to review published research that analyzed causal attributions for breast cancer among women previously diagnosed with breast cancer. These attributions were compared with risk factors identified by published scientific evidence in order to determine the level of agreement between cancer survivors’ attributions and expert opinion.


A comprehensive search for articles, published between 1982 and 2012, reporting studies on causal attributions for breast cancer among patients and survivors was undertaken. Of 5,135 potentially relevant articles, 22 studies met the inclusion criteria. Two additional articles were sourced from reference lists of included studies.


Results indicated a consistent belief among survivors that their own breast cancer could be attributed to family history, environmental factors, stress, fate, or chance. Lifestyle factors were less frequently identified, despite expert health information highlighting the importance of these factors in controlling and modifying cancer risk. This review demonstrated that misperceptions about the contribution of modifiable lifestyle factors to the risk of breast cancer have remained largely unchanged over the past 30 years.


The findings of this review indicate that beliefs about the causes of breast cancer among affected women are not always consistent with the judgement of experts. Breast cancer survivors did not regularly identify causal factors supported by expert consensus such as age, physical inactivity, breast density, alcohol consumption, and reproductive history. Further research examining psychological predictors of attributions and the impact of cancer prevention messages on adjustment and well-being of cancer survivors is warranted.


Breast cancer Attribution Cause Beliefs 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  1. 1.Flinders Centre for Innovation in CancerFlinders UniversityAdelaideAustralia
  2. 2.Cancer Council SAUnley BCAustralia
  3. 3.School of Health SciencesFlinders UniversityAdelaideAustralia
  4. 4.School of Psychology, Social Work and Social PolicyUniversity of South AustraliaAdelaideAustralia

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