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Cancer Screening and Risk-Reducing Behaviors of Women Seeking Genetic Cancer Risk Assessment for Breast and Ovarian Cancers

Deborah J. MacDonald
Linda Sarna
Gwen C. Uman
Marcia Grant
Jeffrey N. Weitzel
ONF 2006, 33(2), E27-E35 DOI: 10.1188/06.ONF.E27-E35

Purpose/Objectives: To examine breast and ovarian cancer screening and risk-reducing behaviors of women seeking genetic cancer risk assessment (GCRA).

Design: Descriptive, cross-sectional.

Setting: An insurance-based clinic that serves high-risk patients in a southern California cancer center.

Sample: 134 women with breast or ovarian cancer (affected group) and 80 women with a family history of breast or ovarian cancer (unaffected group). The mean age of the sample was 48 years (range = 21-86), 79% were Caucasian, 66% were married, 60% were college educated, and 78% had children. Most affected women had early-stage disease. Unaffected women had a family history of breast (86%) or ovarian (14%) cancer.

Methods: Mailed surveys assessed pre-GCRA health behaviors and health and family histories.

Main Research Variables: Breast cancer screening (mammograms, clinical breast examination [CBE], breast self-examination), ovarian cancer screening (CA-125, pelvic ultrasound), and breast and ovarian cancer risk-reducing strategies (tamoxifen, bilateral mastectomy, oral contraceptive pills, bilateral salpingo-oophorectomy).

Findings: Twenty-one percent of the women who should have been having a mammogram had not had an annual examination as recommended, and 30% of affected women had not had annual CBEs. Few women took tamoxifen or oral contraceptive pills or had a bilateral salpingo-oophorectomy or bilateral mastectomy for cancer risk reduction. Twelve percent likely had unnecessary ovarian cancer screening. About 35% used other means, including herbs and homeopathy, for cancer prevention.

Conclusions: Nearly a third of the affected women had not had appropriate breast cancer screening. About 12% used unsubstantiated, potentially harmful cancer "prevention" measures (e.g., herbs).

Implications for Nursing: Nurses should assess clients' personal and family breast and ovarian cancer histories and promote cancer screening and risk-reducing behaviors that are appropriate for age and risk level.

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