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智利服务欠缺地区女性对乳腺癌风险的感知和客观评估。

Perceived and objective breast cancer risk assessment in Chilean women living in an underserved area.

机构信息

School of Public Health, Department of Health Services, University of Washington, Seattle, Washington, USA.

出版信息

Cancer Epidemiol Biomarkers Prev. 2012 Oct;21(10):1716-21. doi: 10.1158/1055-9965.EPI-12-0242. Epub 2012 Jul 26.

Abstract

BACKGROUND

Breast cancer is the most frequently diagnosed malignancy among Chilean women and an increasingly significant public health threat. This study assessed the accuracy of breast cancer risk perception among underserved, Chilean women.

METHODS

Women aged 50 to 70 years, with no mammogram during the last 2 years, were randomly selected from a community clinic registry in Santiago, Chile (n = 500). Perceived risk was measured using three methods: absolute risk, comparative risk, and numerical risk. Risk comprehension was measured by comparing women's perceived and objective risk estimates. Multivariate logistic regression was used to assess overestimation of perceived risk.

RESULTS

Women at high risk of breast cancer were more likely than average risk women to perceive themselves at high or higher risk, using absolute and comparative risk approaches (P < 0.001). The majority of participants (67%) overestimated their breast cancer risk, on the basis of risk comprehension; although, participants achieved higher accuracy with comparative risk (40%) and absolute risk (31.6%) methods. [Age, breast cancer knowledge and Breast Cancer Risk Assessment Tool (BCRAT) 5-year risk were significantly associated (P < 0.01) with accuracy of perceived risk].

CONCLUSION

Chilean women residing in an underserved community may not accurately assess their breast cancer risk, although risk perception and level of accuracy differed between perceived risk measures. Comparative and absolute risk methods may better reflect women's interpretation and accuracy of risk perception.

IMPACT

Improving our understanding of Chilean women's perceptions of developing breast cancer may lead to the development of culturally relevant efforts to reduce the breast cancer burden in this population.

摘要

背景

乳腺癌是智利女性中最常见的恶性肿瘤,也是日益严重的公共卫生威胁。本研究评估了服务不足的智利女性对乳腺癌风险的感知准确性。

方法

从智利圣地亚哥的社区诊所登记处随机选择年龄在 50 至 70 岁之间、过去 2 年内未进行过乳房 X 光检查的女性(n=500)。使用三种方法测量感知风险:绝对风险、相对风险和数值风险。通过比较女性感知和客观风险估计来衡量风险理解。使用多变量逻辑回归评估感知风险的高估。

结果

患有乳腺癌高风险的女性比平均风险的女性更有可能使用绝对和相对风险方法来感知自己处于高或更高风险(P<0.001)。大多数参与者(67%)根据风险理解高估了自己的乳腺癌风险;尽管如此,参与者在比较风险(40%)和绝对风险(31.6%)方法上的准确性更高。[年龄、乳腺癌知识和乳腺癌风险评估工具(BCRAT)5 年风险与感知风险的准确性显著相关(P<0.01)]。

结论

居住在服务不足社区的智利女性可能无法准确评估自己的乳腺癌风险,尽管风险感知和准确性水平因感知风险的衡量方法而异。相对风险和绝对风险方法可能更好地反映了女性对风险的解释和准确性。

影响

深入了解智利女性对患乳腺癌的看法可能会促使制定出针对该人群的文化相关措施来降低乳腺癌负担。

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