Age-related differences in breast carcinoma knowledge, beliefs, and perceived risk among women visiting an academic general medicine practice

Abstract

BACKGROUND. This study assessed whether age-related differences in breast carcinoma knowledge and perceived risk exist among women in a primary care setting and whether these women's beliefs about the best age to begin screening mammography reflect those of their physicians. METHODS. Consecutive women ages 30-70 years who visited an academic general medicine practice were asked to complete a questionnaire assessing breast carcinoma knowledge, beliefs, and perceived risk. Women's risk estimates were compared with individual risk probabilities derived from the Gall model. Women's beliefs about when to begin screening mammography were compared with the beliefs of the attending physicians in the practice. Questionnaire results were compared across age groups. RESULTS. Six hundred seventy-four women completed the survey. Overall, knowledge scores were negatively correlated with age (correlation coefficient = -0.30, P = 0.001). The level of knowledge about the benefits of mammography was high across all ago groups. In contrast, knowledge that 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 all women, 26% underestimated their risk of developing breast carcinoma in the next 10 years, 32% correctly estimated their risk, and 42% overestimated their risk. Fifty-five percent thought that mammography should begin when a woman is age 30-35 years. In contrast, all surveyed physicians recommended that a woman start undergoing mammography at age 40 years or older. CONCLUSIONS. In this primary care setting, older women had poorer breast 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 females by their physicians may resolve some of the observed discrepancies regarding the optimal age to begin screening mammography.