Risk perception and psychological strain in women with a family history ofbreast cancer

Background: The thinking in health psychology is that patients' willingness to adopt preventive health behavior is contingent on their perceiving an i ncreased risk of disease and is influenced by accompanying psychological st ress. In counseling women with a family history of breast cancer, physician s focus on encouraging the patient to undergo early detection examinations as recommended. Therefore, it is essential to examine how women in this ris k group perceive their own chances of developing breast cancer and to asses s the psychological effects of their situation. Material and Methods: 129 w omen with at least one first or second degree relative who had developed br east cancer were enrolled in a questionnaire study. The object was to ascer tain the extent to which these women may be expected to realistically estim ate their own probability of contracting the disease and what influence ris k perception and psychological strain have on their willingness to make use of diagnostic opportunities for early detection. Additionally, the effects on their physical and mental well-being were analyzed. Results: Among the women of the study group, a family history of breast cancer did not always correlate with the subject's perception of an increased risk of contracting the disease compared. On the whole, the majority of the women overestimate d their personal risk despite prior genetic counseling. Only slightly less than one quarter of the study group correctly estimated their risk; another quarter underestimated it. The majority of those women who exhibited an in creased risk perception were also those who overestimated their probability of personally contracting the disease. They underwent recommended screenin g examinations significantly less often than women with a low risk percepti on. However, women subjected to intense psychological strain showed above-a verage participation in screening programs. Conclusions: Women with a famil y history of breast cancer often find it difficult to realistically estimat e their own risk of contracting the disease. Increased risk perception had a negative effect on participation in recommended breast cancer screening. Therefore, an effort should be made to correct the patient's overestimation of her personal risk. Integrating psychological counseling in screening pr ograms is essential considering that women from high-risk groups are subjec ted to increased psychological strain. Further studies are required to more precisely evaluate other psychosocial factors in the behavior of women in risk group toward screening.