Breast Cancer Risk, Risk Perception and Lifestyle Behaviors among Women with a Family History of the Disease: A Mixed-Method Approach Public Deposited

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  • March 20, 2019
  • Spector, Denise Jean
    • Affiliation: School of Nursing
  • Family history is one of the most influential breast cancer risk factors. Several lifestyle factors are also related to elevated breast cancer risk. Little is known about relationships between a family history of breast cancer, risk perception, and lifestyle behaviors. We explored relationships between participant characteristics, Gail Model risk estimates, risk perceptions and lifestyle behaviors. Overall aims were to: 1) determine if objective risk and family burden of disease relate to lifestyle behaviors, 2) explore whether there are differences between Black and White women in lifestyle behaviors and 3) increase understanding about factors involved in breast cancer risk perception and how they relate to lifestyle behaviors. This study utilized a mixed-method design. The quantitative portion involved analyses of risk-related variables from the baseline questionnaire of the Sister Study (N=19,418), a national epidemiological study assessing links between exposures to potential risk factors and subsequent development of breast cancer in women between the ages of 35-74 who do not have breast cancer, but have at least one sister diagnosed with breast cancer. Multivariable logistic regression was conducted to determine whether associations existed between objective risk and lifestyle behaviors (e.g., physical activity, diet, alcohol intake, and smoking). Women were then stratified on race and logistic regression was conducted to detect any differences between Black and White women. A qualitative descriptive approach (i.e., personal interviews) was used in a complementary fashion to explore factors involved in risk perception formulation. Eligibility criteria were active enrollment in the Sister Study and living in North Carolina. Lifestyle behaviors did not significantly differ among women at varying levels of perceived risk or objective breast cancer risk. Qualitative descriptive findings revealed that many women were unaware of associations between lifestyle-related behaviors and breast cancer risk. Most women were not adhering to lifestyle-related recommendations for breast cancer risk-reduction. Results improve knowledge about relationships between objective risk, perceived risk and lifestyle behaviors. Further study is needed to support these results and to explain the lack of relationships between perceived risk/objective risk and modification of lifestyle behaviors in women at elevated breast cancer risk.
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  • Mishel, Merle H.
  • Open access

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