277 Risk perception and distress among women attending a breast cancer family clinic

Abstract

One hundred and forty-nine women were assessed before and after attending the clinic to assess the impact of counselling on their perception of their risk of developing breast cancer and on their levels of anxiety and psychological distress. Women who initially underestimated their risk (i.e. ≤ 0.5 × counselled risk) continued to underestimate their risk (t=2.72, P=0.01) but to a lesser degree (t=4.6, <i>P</i>=0.001) after counselling; those who overestimated initially (≥ 2 × counselled risk) continued to do so (t=2.53, <i>P</i>=0.02) but to lesser extent (t=4.3, <i>P</i>=0.001) after counselling. Changes in anxiety (A), and psychological distress (General Health Questionnaire––(GHQ)) scores varied with initial accuracy of risk estimate (A: F=3.89, <i>P</i>=0.02; GHQ: F=4.3, <i>P</i>=0.02). For overestimators anxiety and distress fell significantly immediately after counselling (A: t=2.48, <i>P</i>=0.02; GHQ: t=2.50, <i>P</i>=0.02) but returned to baseline by 3 month follow-up. Accurate estimators showed a similar response. Contrary to expectations, underestimators showed no significant increase in anxiety or GHQ scores. Although the clinic appears to increase accuracy of perception of breast cancer risk without causing distress to those who initially underestimated their risk, the reassurance it offers others appears short lived. The implications will be discussed.