Tailored risk notification for women with a family history of breast cancer

Background Evidence indicates that although first-degree relatives of breas t cancer cases are at increased risk of developing the disease themselves, they may be underutilizing screening mammography. Therefore, interventions to increase the use of mammography in this group are urgently needed. Methods. A randomized two-group design was used to evaluate an intervention to increase mammography use among women (N = 901) with at least one first- degree relative with breast cancer. A statewide cancer registry was used to obtain a random sample of breast cancer cases who identified eligible rela tives. The mailed intervention consisted of personalized risk notification and other theoretically driven materials tailored for high-risk women. Results. An overall significant intervention effect was observed (8% interv ention group advantage) in mammography at post-test. There was an interacti on of the intervention with age such that there was no effect among women < 50 years of age and a fairly large (20% advantage) effect among women 50+ a nd 65+. Health insurance, education, and having had a mammogram in the year before baseline assessment were positive predictors of mammography at post -test. Perceived risk, calculated risk, and relationship to index cancer ca se were not associated with mammography receipt. Conclusion. The intervention was successful in increasing mammography rates among high-risk women 50+ years of age. Further work is needed to determin e why it was ineffective among younger women. (C) 1999 American Health Foun dation and Academic Press.