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Predictors of Cancer Worry in Unaffected Women from High Risk Breast Cancer Families: Risk Perception is not the Primary Issue

  • Original Research
  • Published:
Journal of Genetic Counseling

Abstract

Some women at increased familial risk of breast cancer experience elevated levels of cancer-specific worry, which can possibly act as a barrier to screening, and may be a significant factor in decisions regarding risk-reducing surgery. The aim of this study was to comprehensively examine predictors of cancer-specific worry in high risk women and to test a model which proposes that perceived breast cancer risk mediates the impact of other factors on worry. 1,437 unaffected women from high risk breast cancer families completed questionnaires and interviews. Path analysis was used to test the model of potential predictors of cancer worry, including familial, personal and psychological variables, mediated via perceived cancer risk. Levels of cancer-specific worry were generally low despite an average perceived risk of 50.3%. The goodness-of-fit of the proposed model was poor, explaining only 9% of the variance for perceived risk and 10% of the variance for cancer specific worry. An alternative model of a direct relationship between all of the predictor variables and cancer worry, explained 24% of the variation in cancer worry. General anxiety, perceived risk, the stressful impact of recent cancer related events, a relative risk greater than 10, being closer in age to the youngest breast cancer diagnosis in family, and knowledge of personal mutation status, all independently contributed to cancer worry. Addressing general affective responses, experiences of recent cancer related events, in addition to education about personal risk, should be considered in counselling women with elevated cancer worry. Risk perception appears to act independently of other factors in its formulation and impact on cancer worry. Further research on the way in which women come to perceive their risk is indicated.

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Acknowledgements

We wish to thank Heather Thorne, Eveline Niedermayr, all the kConFab research nurses and staff, and the Clinical Follow Up Study, in particular Prue Weiderman and Joanne McKinley (funded by NHMRC grants 145684 and 288704) for their contributions to this resource, and the many families who contribute to kConFab. kConFab is supported by grants from the National Breast Cancer Foundation, the National Health and Medical Research Council (NHMRC) and by the Queensland Cancer Fund, the Cancer Councils of New South Wales, Victoria, Tasmania and South Australia, and the Cancer Foundation of Western Australia.

Competing interests

None

Funding: National Health and Medical Research Council of Australia, Project Grants No. 153824 and 301930; School of Psychology Postdoctoral Research Fellowship, University of Sydney (M Price), NHMRC Senior Research Fellowship (P Butow).

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Authors and Affiliations

  1. Medical Psychology Research Unit, School of Psychology, Brennan MacCallum Building (A18), University of Sydney, Sydney, Australia

    Melanie Anne Price, Phyllis Noami Butow & Judy Wilson

  2. Faculty of Health, Medicine, Nursing & Behavioural Sciences, Deakin University, Geelong, Australia

    Sing Kai Lo

Authors
  1. Melanie Anne Price
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  2. Phyllis Noami Butow
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  3. Sing Kai Lo
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  4. Judy Wilson
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Kathleen Cuningham Consortium for Research into Familial Breast Cancer (kConFab) Psychosocial Group

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Correspondence to Melanie Anne Price.

Additional information

The kConFab Psychosocial Group are (in alphabetical order of institution): Brain and Mind Institute, University of Sydney, Australia (I Hickie) Department of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia (K-A Phillips) Department of Medical Oncology, Prince of Wales Hospital, Randwick, Australia (B Bennett, B Meiser, K Tucker) Department of Oncology, St Vincent’s Hospital, Melbourne, Australia (S-A MaLachlan) Department of Psychological Medicine, Royal North Shore Hospital, St Leonards, Australia (C Tennant); Medical Psychology Research Unit, University of Sydney, Australia (P Butow, M Price).

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Price, M.A., Butow, P.N., Lo, S.K. et al. Predictors of Cancer Worry in Unaffected Women from High Risk Breast Cancer Families: Risk Perception is not the Primary Issue. J Genet Counsel 16, 635–644 (2007). https://doi.org/10.1007/s10897-007-9105-4

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  • DOI: https://doi.org/10.1007/s10897-007-9105-4

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