Cancer Worry in Women With Hereditary Risk Factors for Breast Cancer
Purpose/Objectives: To investigate symptom-based cancer worry in women who are at hereditary risk for breast cancer, specifically levels of worry, correlations of cancer worry, perceived cancer risk, and clinical signs or symptoms of breast cancer, as well as predictors of cancer worry.
Design: Cross-sectional, correlational.
Setting: Primarily the United States.
Sample: 200 women, aged 18-80, with no personal history of cancer, who met at least one established criterion of hereditary breast cancer risk were recruited primarily from a mammography facility and cancer prevention clinics or via network sampling.
Methods: Completion of the following self-report instruments: Thoughts About Cancer Scale and measures of clinical symptoms, perceived risk, and sample characteristics. Data analysis consisted of descriptive statistics, Pearson correlations, and binary logistic regression.
Main Research Variables: Cancer worry, total clinical signs of cancer, perceived cancer risk, age, and family history.
Findings: Participants sometimes worried about breast cancer but had more general breast cancer worry than worry based on perceived neutral or breast cancer-specific symptoms. Total clinical signs of breast cancer correlated significantly with cancer worry. Women aged 41-50 and those with more clinical signs of breast cancer were 3.76 and 1.49 times more likely to have high worry, respectively.
Conclusions: Moderate worry in high-risk women is not unusual. Total symptoms and younger age predict higher breast cancer worry, whereas perceived risk and family history do not.
Implications for Nursing: Counseling of young, high-risk women should include assessments of worry and clinical signs of breast cancer.
Jump to a section
References
Audrain, J., Schwartz, M.D., Lerman, C., Hughes, C., Peshkin, B.N., & Biesecker, B. (1997). Psychological distress in women seeking genetic counseling for breast-ovarian cancer risk: The contributions of personality and appraisal. Annals of Behavioral Medicine, 19, 370-377.
Baider, L., Ever-Hadani, P., & De-Nour, A.K. (1999). Psychological distress in healthy women with familial breast cancer: Like mother, like daughter? International Journal of Psychiatry in Medicine, 29, 411-420.
Bentler, P.M., & Wu, E.J.C. (1995). EQS for Windows. Encino, CA: Multivariate Software, Inc.
Bish, A., Sutton, S., Jacobs, C., Levene, S., Ramirez, A., & Hodgson, S. (2002). Changes in psychological distress after cancer genetic counseling: A comparison of affected and unaffected women. British Journal of Cancer, 86, 43-50.
Bowen, D., McTiernan, A., Burke, W., Powers, D., Pruski, J., Durfy, S., et al. (1999). Participation in breast cancer risk counseling among women with a family history. Cancer Epidemiology, Biomarkers, and Prevention, 8, 581-585.
Brain, K., Gray, J., Norman, P., France, E., Anglim, C., Barton, G., et al. (2001). Randomized trial of a specialist genetic assessment service for familial breast cancer. Journal of the National Cancer Institute, 92, 1345-1351.
Brain, K., Norman, P., Gray, J., & Mansel, R. (1999). Anxiety and adherence to breast self-examination in women with a family history of breast cancer. Psychosomatic Medicine, 61, 181-187.
Chalmers, K., & Thomson, K. (1996). Coming to terms with breast cancer: Perceptions of women with primary relatives with breast cancer. Qualitative Health Research, 6, 256-282.
Cull, A., Fry, A., Rush, R., & Steel, C.M. (2001). Cancer risk perceptions and distress among women attending a familial ovarian cancer clinic. British Journal of Cancer, 84, 594-599.
Cunningham, L.L.C., Andrykowski, M.A., Wilson, J.F., McGrath, P.C., Sloan, D.A., & Keady, D.E. (1998). Physical symptoms, distress, and breast cancer risk perceptions in women with benign breast problems. Health Psychology, 17, 371-375.
Diefenbach, M.A., Miller, S.M., & Daly, M.B. (1999). Specific worry about breast cancer predicts mammography use in women at risk for breast and ovarian cancer. Health Psychology, 18, 532-536.
Easterling, D.V., & Leventhal, H. (1989). Contributions of concrete cognition to emotion: Neutral symptoms as elicitors of worry about cancer. Journal of Applied Psychology, 74, 787-796.
Hopwood, P., Keeling, F., Long, A., Pool, C., Evans, G., & Howell, A. (1998). Psychological support needs for women at high genetic risk of breast cancer: Some preliminary indicators. Psycho-Oncology, 7, 402-412.
Imle, M.A., & Atwood, J.R. (1988). Retaining qualitative validity while gaining quantitative reliability and validity: Development of the Transition to Parenthood Concerns Scale. Advances in Nursing Science, 11(1), 61-75.
Kash, K., Holland, J.C., Halper, M.S., & Miller, D.G. (1992). Psychological distress and surveillance behaviors of women with a family history of breast cancer. Journal of the National Cancer Institute, 84, 24-30.
Kash, K.M., Holland, J.C., Osborne, M.P., & Miller, D.G. (1995). Psychological counseling strategies for women at risk of breast cancer. Journal of the National Cancer Institute Monographs, 17, 73-79.
Leggatt, V., Mackay, J., Marteau, T.M., & Yates, J.R.W. (2000). The psychological impact of a cancer family history questionnaire completed in general practice. Journal of Medical Genetics, 37, 470-472.
Lerman, C., Daly, M., Masny, A., & Balshem, A. (1994). Attitudes about genetic testing for breast-ovarian cancer susceptibility. Journal of Clinical Oncology, 12, 843-850.
Lerman, C., Daly, M., Sands, C., Balshem, A., Lustbader, E., Heggan, T., et al. (1993). Mammography adherence and psychological distress among women at risk for breast cancer. Journal of the National Cancer Institute, 85, 1074-1080.
Lerman, C., Rimer, B.K., Daly, M., Lustbader, E., Sands, C., Balshem, A., et al. (1994). Recruiting high risk women into a breast cancer health promotion trial. Cancer Epidemiology, Biomarkers, and Prevention, 3, 271-276.
Lerman, C., Schwartz, M.D., Miller, S., Daly, M., Sands, C., & Rimer, B.K. (1996). A randomized trial of breast cancer risk counseling: Interacting effects of counseling, educational level, and coping style. Health Psychology, 15, 75-83.
Lloyd, S., Watson, S., Waites, B., Meyer, L., Eeles, R., Ebbs, S., et al. (1996). Familial breast cancer: A controlled study of risk perception, psychological morbidity, and health beliefs in women attending for genetic counseling. British Journal of Cancer, 74, 482-487.
Loescher, L.J. (2001). Perceived risk of inherited susceptibility to cancer©. Ann Arbor, MI: UMI Company.
Lynch, H.T., & Lynch, J.E. (1991). Familial factors and genetic predisposition to cancer: Population studies. Cancer Detection and Prevention, 15, 49-57.
McCaul, K.D., Branstetter, A.D., O'Donnell, S.M., Jacobsen, K., & Quinlan, K.B. (1998). A descriptive study of breast cancer worry. Journal of Behavioral Medicine, 21, 565-579.
Nunnally, J.C., & Bernstein, I. (1994). Psychometric theory. New York: McGraw-Hill.
Polit, D.F., & Hungler, B.P. (1995). Nursing research: Principles and methods. Philadelphia: Lippincott.
Streiner, D.L., & Norman, G.R. (1995). Health measurement scales. New York: Oxford University Press.
Trask, P.C., Paterson, A.G., Wang, C., Hayasaka, S., Milliron, K.J., Blumberg, L.R., et al. (2001). Cancer-specific worry interference in women attending a breast and ovarian cancer risk evaluation program: Impact on emotional distress and health functioning. Psycho-Oncology, 10, 349-360.
Weber, B.L., & Garber, J.E. (1993). Family history and breast cancer: Probabilities and possibilities. JAMA, 270, 1602-1603.
Weinstein, N.D. (1988). The precaution adoption process. Health Psychology, 7, 355-386.
Weinstein, N.D., Grubb, P.D., & Vautier, J.S. (1986). Increasing automobile seat belt use: An intervention emphasizing risk susceptibility. Journal of Applied Psychology, 71, 285-290.