How Do Underserved Minority Women Think about Breast Cancer Risk?

Abstract

The goal of this project is to identify the potential ethical implications of an FQHC clinic-wide policy to provide female patients ages 25-70 with personalized breast cancer risk information. In our partner FQHC, breast cancer risk will be assessed using a computerized tool developed using models that are widely used in clinical practice. The impact of providing personalized breast risk cancer information on patient adherence to recommended screening and risk reduction measures will be evaluated by the parent study.

While it is hypothesized that personalized risk assessment will improve adherence to national screening and prevention guidelines (particularly for those women in higher risk categories), the potential psychosocial harms and benefits of personalized breast cancer risk assessment in this particular population are not fully known. Information about risk perceptions, the value of individualized risk assessment, and preferences regarding recommended surveillance and prevention strategies is also limited.

This supplement will support the collection of data from FQHC patients and primary care physicians (PCP) using qualitative methodologies prior to full implementation of the policy. We will analyze audio recordings of patient-physician conversations about individualized breast cancer risk and conduct in-depth interviews with patients and physicians. Understanding of patient and PCP views on ethical implications of personalized breast cancer risk assessment will inform development of an approach to risk communication that promotes respect for individual patient autonomy and provides appropriate support to patients in all risk strata. Recommendations will be made to refine physician training and patient education materials.

In the context of an FQHC clinic-wide policy to assess breast cancer risk in female patients ages 25-70, this study will pursue the following aims:

  1. Examine patient and primary care physician perspectives on the potential harms [e.g., increased psychological distress] and benefits [e.g., reassurance about breast cancer risk, prevention and early detection] of receiving personalized breast cancer risk information.
  2. Examine patient values and preferences regarding breast cancer risk communication, surveillance, and risk reduction measures.
  3. Explore modifiable factors [e.g., physician communication, comprehension] that influence patient psychological distress in reaction to personalized breast cancer risk information.
  4. Integrate findings to refine physician education and delivery of breast cancer risk information to support informed decision-making, enhance benefits, and reduce risks to patients.

Affiliated Center/Program

Funding Agency

National Cancer Institute of the National Institutes of Health (Grant No. 3P50CA106743-07S2)

Start date
07/01/2011
End date
06/30/2013
Total award
$200,000
About this grant

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See the center's publications prior to July 2010.