AGE-RELATED DIFFERENCES IN BREAST-CARCINOMA KNOWLEDGE, BELIEFS, AND PERCEIVED RISK AMONG WOMEN VISITING AN ACADEMIC GENERAL MEDICINE PRACTICE

BACKGROUND. This study assessed whether age-related differences in bre ast carcinoma knowledge and perceived risk exist among women in a prim ary care setting and whether these women's beliefs about the best age to begin screening mammography reflect those of their physicians. METH ODS. Consecutive women ages 30-70 years who visited an academic genera l medicine practice were asked to complete a questionnaire assessing b reast carcinoma knowledge, beliefs, and perceived risk. Women's risk e stimates were compared with individual risk probabilities derived from the Gall model. Women's beliefs about when to begin screening mammogr aphy were compared with the beliefs of the attending physicians in the practice. Questionnaire results were compared across age groups. RESU LTS. Six hundred seventy-four women completed the survey. Overall, kno wledge scores were negatively correlated with age (correlation coeffic ient = -0.30, P = 0.001). The level of knowledge about the benefits of mammography was high across all age groups. In contrast, knowledge th at breast carcinoma incidence increases with age was poor. Only 28% of all women recognized that breast carcinoma is more common among women age 65 years than among women age 40 years. Among ail women, 26% unde restimated their risk of developing breast carcinoma in the next 10 ye ars, 32% correctly estimated their risk, and 42% overestimated their r isk. Fifty-five percent thought that mammography should begin when a w oman is age 30-35 years. In contrast, all surveyed physicians recommen ded that a woman start undergoing mammography at age 40 years or older . CONCLUSIONS. In this primary care setting, older women had poorer br east carcinoma knowledge than younger women but were equally likely to appreciate the benefits of mammography. Most women were unaware that age is a risk factor for breast carcinoma. Improved education of femal es by their physicians may resolve some of the observed discrepancies regarding the optimal age to begin screening mammography. (C) 1997 Ame rican Cancer Society.