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Missed opportunities: family history and behavioral risk factors in breast cancer risk assessment among a multiethnic group of women.

Abstract：

BACKGROUND:Clinician's knowledge of a woman's cancer family history (CFH) and counseling about health-related behaviors (HRB) is necessary for appropriate breast cancer care. OBJECTIVE:To evaluate whether clinicians solicit CFH and counsel women on HRB; to assess relationship of well visits and patient risk perception or worry with clinician's behavior. DESIGN:Cross-sectional population-based telephone survey. PARTICIPANTS:Multiethnic sample; 1,700 women from San Francisco Mammography Registry with a screening mammogram in 2001-2002. MEASUREMENTS: PREDICTORS:well visit in prior year, self-perception of 10-year breast cancer risk, worry scale. OUTCOMES:Patient report of clinician asking about CFH in prior year, or ever counseling about HRB in relation to breast cancer risk. Multivariate models included age, ethnicity, education, language of interview, insurance/mammography facility, well visit, ever having a breast biopsy/follow-up mammography, Gail-Model risk, Jewish heritage, and body mass index. RESULTS:58% reported clinicians asked about CFH; 33% reported clinicians ever discussed HRB. In multivariate analysis, regardless of actual risk, perceived risk, or level of worry, having had a well visit in prior year was associated with increased odds (OR = 2.3; 95% CI 1.6, 3.3) that a clinician asked about CFH. Regardless of actual risk of breast cancer, a higher level of worry (OR = 1.9; 95% CI 1.4, 2.6) was associated with increased odds that a clinician ever discussed HRB. CONCLUSIONS:Clinicians are missing opportunities to elicit family cancer histories and counsel about health-related behaviors and breast cancer risk. Preventive health visits offer opportunities for clinicians to address family history, risk behaviors, and patients' worries about breast cancer.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Karliner LS,Napoles-Springer A,Kerlikowske K,Haas JS,Gregorich SE,Kaplan CP

doi

10.1007/s11606-006-0087-y

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

308-14

issue

eissn

0884-8734

issn

1525-1497

journal_volume

pub_type

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Missed opportunities: family history and behavioral risk factors in breast cancer risk assessment among a multiethnic group of women.