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Screening behavior in women at increased familial risk for breast cancer

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Abstract

This multicenter study examined the adherence of high-risk women to screening recommendations for breast and ovarian cancer following consultation at a familial cancer clinic (FCC). Self-report questionnaires assessing recall of screening advice, tests undertaken, risk perception, anxiety (Impact of Events Scale) and demographics were mailed to 396 consecutive eligible women who had attended one of six FCCs a median of 3.6 years prior. Family history, genetic test results and screening recommendations were abstracted from medical records. 182/266 (68.4%) women responded with 130 lost to follow-up. The proportions of women undertaking at least the recommended frequency of screening tests were: breast␣self examination (BSE) 50.4%, clinical breast examination (CBE) 66.0%, mammography 82.2%, transvaginal ultrasound (TVUS) 70.0%, CA125 84.0%. Factors associated with adherence to screening were: higher anxiety for BSE and CBE, being BRCA1/2 positive for CBE, older age, method of arrangement and having at least one affected first degree relative for mammography. Factors significantly associated with over-adherence were higher scores for anxiety for BSE and CBE and younger age (< 40 years) for TVUS. Between 41.3% (BSE) and 57.6% (CBE) of women incorrectly recalled their screening recommendations. A substantial minority of high-risk women do not adhere to screening advice. Strategies to improve the accuracy of recall of recommendations and the uptake of recommended screening are required.

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Abbreviations

FCC:

Familial Cancer Centre

BSE:

Breast Self Examination

CBE:

Clinical Breast Examination

TVUS:

Transvaginal Ultrasound

BC:

Breast Cancer

OC:

Ovarian Cancer

CIN:

Carcinoma Intraepithelial Neoplasia

CI:

Confidence Interval

Mod:

Moderate

AUD:

Australian Dollars

No.:

Number

Mammo:

Mammogram

n/a:

not applicable

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Acknowledgements

We thank Jane Matthews and Bettina Meiser for assistance with protocol development, Geoff Lindeman, Lesley Andrews and Sheridan O’Donnell for data collection and Gillian Mitchell for critical review of an earlier version of the manuscript.

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Correspondence to Kelly-Anne Phillips.

Additional information

This study was supported by the National Breast Cancer Centre, Australia.

Yoland Antill is the recipient of a Goodman Fielder National Breast Cancer Foundation Scholarship.

Kelly-Anne Phillips is the Cancer Council Victoria, Dr John Colebatch Clinical Research Fellow

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Antill, Y., Reynolds, J., Young, M.A. et al. Screening behavior in women at increased familial risk for breast cancer. Familial Cancer 5, 359–368 (2006). https://doi.org/10.1007/s10689-006-0006-8

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  • DOI: https://doi.org/10.1007/s10689-006-0006-8

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