Variations in subjective breast cancer risk estimations when using different measurements for assessing breast cancer risk perception

Abstract

Objective: To investigate whether different measurements for breast cancer risk perception can lead to variations in breast cancer risk estimations and to different conclusions about risk accuracy.

Methods: Women with no history of breast cancer (N = 377) estimated their breast cancer risk on four different scales (percentage scale, visual analogue scale, 7-point scale, comparative scale). We examined the associations between the risk estimations and assessed women's confidence in risk judgements.

Results: Women overestimated their breast cancer risk on the percentage and visual analogue scales. In contrast, judgements on the 7-point scale indicated a more adequate risk perception, whereas on the comparative scale women tended to underestimate their breast cancer risk. Women felt least confident in their judgement on the percentage scale and most confident using the comparative scale. Conclusions: Some scales for assessing breast cancer risk perception (e.g., percentages) might trigger increased uncertainty, which in turn may provoke risk estimations which do not accurately reflect women's actual views and feelings about their breast cancer risk. Thus, due to differences in confidence in risk judgements, different scales might lead to dissimilar risk estimations and thus to different and potentially invalid conclusions about subjective breast cancer risk concepts.

Keywords:

• Breast neoplasm
• risk perception
• measurement
• communication

Acknowledgements

This research was supported by grants from the German Ministry of Education and Research (01KU9903). The authors would like to thank all women who participated in this study as well as our colleagues Melanie Jung, Christian Klesse, Kerstin Kolodziej and Vera Meyer-Borgstädt for their support in data collection. We also would like to thank Professor Deborah Bowen (Seattle) and Dr. Markus Wirtz for helpful comments on a former draft.