Breast Cancer Risk Perception of First Degree Female Relatives of Breast Cancer Patients Influences Their Risk Reduction Behaviors: A Pre-Study Assessment

Abstract

Background: Breast cancer is the second most common cancer affecting women worldwide. There is an increased risk of breast cancer among the first degree relatives. Perceived risk relates to an individual's belief about the probability or likelihood of developing some specified illness. Cancer fatalism is the belief that cancer is predetermined, beyond individual control, and necessarily fatal. Aim: To assess the self-perceived risk of breast cancer and screening and risk reduction behaviors among the first degree female relatives of breast cancer patients. Findings from this study can inform interventions to increase uptake of breast cancer screening services among relatives of breast cancer patients in low- and middle-income countries (LMICs). The results formed a baseline for designing a study on risk perception and risk reduction practices among first degree female relatives of patients diagnosed with breast cancer at Uganda Cancer Institute, Kampala, Uganda. Methods: Review of literature on risk perception and risk reduction practices of first degree relatives of breast cancer patients. We searched through various literature published in PubMed and oncology journals in HINARI published in English. All the studies were conducted among female relatives of breast cancer patients from world. All eligible papers were included in the review. The papers were carefully appraised to identify key outcomes of the studies. Results: Women were engaged in risk reduction behaviors like smoking cessation, reduction in alcohol intake, physical activity and screening for breast cancer. Women aged 54 years and below had a higher perceived lifetime risk of breast cancer (39.5%) compared with those aged ≥ 55 years (30.6%) who perceived themselves at lower risk. Levels of education have also been found key in determining an individual's perceived risk. Being unrealistically optimistic was significantly associated with high level of educational attainment while women who did not know their risk were less educated. Socioeconomic status has also been seen to influence breast cancer perceived risk. Unrealistic pessimism was frequent among women with a higher income status although a greater proportion of women who accurately perceived their 5-year risk of breast had a higher annual income. There was a significant association of the stage of breast cancer, time since diagnosis and perceived breast cancer risk among the relatives. Fatalistic beliefs about cancer prevention influenced prevention behaviors by promoting a sense of external locus of control changing beliefs about the value of specific behaviors, or reducing self-efficacy and motivation to perform prevention behaviors. Conclusion: High risk perception is associated with increase need to engage in risk reduction behaviors. Fatalism among women was the primary reason not to engage in breast cancer screening.