Breast cancer worry, uncertainty, and perceived risk following breast density notification in a longitudinal mammography screening cohort.
Breast cancer worry, uncertainty, and perceived risk following breast density notification in a longitudinal mammography screening cohort.
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DOI：
10.1186/s13058-022-01584-2
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发表时间：
2022-12-21
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密集乳房通知（DBN）立法旨在提高妇女对其个人乳房密度的认识，以及拥有密集乳房对乳腺癌检测和风险的影响。这些信息可能会对女性的乳腺癌担忧，风险认知和筛查的不确定性产生不利影响，这些因素可能会随着时间的推移而持续存在或因社会人口因素而异。我们研究了对DBN的短期和长期心理反应以及对乳腺密度（BD）的认识。在一个以西班牙裔为主的纽约市筛查队列（63%讲西班牙语）中，年龄在40-60岁之间，我们评估了乳腺癌的担忧，感知的乳腺癌风险以及乳腺癌风险和筛查选择的不确定性，在2016年至2018年期间的登记筛查乳房X光检查后进行了短期（1-3个月）和长期（9-18个月）调查。我们比较了妇女的致密乳腺状态（作为代理DBN接收）和BD意识的心理反应，并研究了教育，健康素养，出生，和首选的面试语言的乘法交互。在使用短期调查的多变量模型中，BD意识与感知风险增加相关（高风险的比值比（OR）2.27，95%置信区间（CI）0.99，5.20，中度风险的OR 2.19，95% CI 1.34，3.58，与低风险相比），风险的不确定性增加（OR 1.97/1单位增加，95% CI 1.15，3.39）和筛查选择的不确定性（OR 1.73/1单位增加，95% CI 1.01，2.9）。DBN与至少受过一些大学教育的女性的感知风险降低有关（OR 0.32，95% CI 0.11，0.89，高风险，OR 0.50，95% CI 0.29，0.89，中度与低风险），而高中或以下学历的人经历了增加（OR 3.01，95% CI 1.05，8.67高风险vs低风险）。在DBN或BD意识与短期乳腺癌担忧之间没有观察到任何关联，也没有与长期调查中的任何心理结果相关。BD意识和通知与乳腺癌相关的心理结果的关联仅限于短期内增加的感知乳腺癌风险依赖于教育程度，以及在讲西班牙语的妇女中乳腺癌风险和筛查选择的不确定性增加。在线版本包含补充材料，可通过10.1186/s13058-022-01584-2获得。
Dense breast notification (DBN) legislation aims to increase a woman’s awareness of her personal breast density and the implications of having dense breasts for breast cancer detection and risk. This information may adversely affect women’s breast cancer worry, perceptions of risk, and uncertainty about screening, which may persist over time or vary by sociodemographic factors. We examined short- and long-term psychological responses to DBN and awareness of breast density (BD). In a predominantly Hispanic New York City screening cohort (63% Spanish-speaking), ages 40–60 years, we assessed breast cancer worry, perceived breast cancer risk, and uncertainties about breast cancer risk and screening choices, in short (1–3 months)- and long-term (9–18 months) surveys following the enrollment screening mammogram (between 2016 and 2018). We compared psychological responses by women’s dense breast status (as a proxy for DBN receipt) and BD awareness and examined multiplicative interaction by education, health literacy, nativity, and preferred interview language. In multivariable models using short-term surveys, BD awareness was associated with increased perceived risk (odds ratio (OR) 2.27, 95% confidence interval (CI) 0.99, 5.20 for high, OR 2.19, 95% CI 1.34, 3.58 for moderate, vs. low risk) in the overall sample, and with increased uncertainty about risk (OR 1.97 per 1-unit increase, 95% CI 1.15, 3.39) and uncertainty about screening choices (OR 1.73 per 1-unit increase, 95% CI 1.01, 2.9) in Spanish-speaking women. DBN was associated with decreased perceived risk among women with at least some college education (OR 0.32, 95% CI 0.11, 0.89, for high, OR 0.50, 95% CI 0.29, 0.89, for moderate vs. low risk), while those with a high school education or less experienced an increase (OR 3.01, 95% CI 1.05, 8.67 high vs. low risk). There were no associations observed between DBN or BD awareness and short-term breast cancer worry, nor with any psychological outcomes at long-term surveys. Associations of BD awareness and notification with breast cancer-related psychological outcomes were limited to short-term increases in perceived breast cancer risk dependent on educational attainment, and increases in uncertainty around breast cancer risk and screening choices among Spanish-speaking women. The online version contains supplementary material available at 10.1186/s13058-022-01584-2.
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影响因子：
3.2
作者：
April-Sanders, Ayana;Oskar, Sabine;Tehranifar, Parisa
通讯作者：
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影响因子：
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影响因子：
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