Older Women May Underestimate Their Breast Cancer Risk

NEW YORK—Almost half the women age 65 and over in the United States think they are not at risk for breast cancer or that they are at low risk, according to a national survey from the sponsors of National Breast Cancer Awareness Month (NBCAM).

The survey also found that if this group of women were told they were at higher risk, they would still be less likely to get annual mammograms than younger women receiving similar warnings. These were among the findings of a poll of 854 women over 40 years of age across the nation.

Although the majority said they were either very or somewhat familiar with the risk factors for developing breast cancer, 90% could not identify the important risk factors for breast cancer—56% named family history, a proven risk factor, while 19% named diet, which is not a proven risk factor. Only 8% cited age or growing older, and only 7% cited previous breast cancer history.

Nevertheless, the survey found that breast cancer is the disease the majority of women age 40 and over fear the most: 32% said they worried about getting breast cancer; 24% worried about heart disease; 14% worried about osteoporosis; 9% about uterine cancer, and 5% about depression. Thirteen percent did not cite any disease, and the remaining 3% cited a variety of other disorders.

Half of the women polled said they would be more rigorous about having annual mammograms if their physicians told them they were at higher risk. Yet the women who were 65 and over would be less likely to act on this information than would women age 40 to 54 who received similar warnings.

The study also found that African-American women would be more likely to get regular mammograms than white women if told they were at higher risk for breast cancer.

What women know and think about breast cancer is particularly important in light of the numerous scientific advances that have occurred recently in the fight against the disease, said Bernadine Healy, MD, dean of the College of Medicine and Public Health of Ohio State University and former director of the National Institutes of Health.

Speaking at a press conference held to announce the survey results, Dr. Healy said, “Advances must be translated into the minds and hearts of the individual woman who must constantly be aware of what she can do to alter her own risk.”

Dr. Healy recalled the days when she first started practicing medicine: Breast cancer was a family secret, and radical mastectomy was the only treatment.

Much of the credit for today’s heightened breast cancer awareness should go to advocacy groups and women, Dr. Healy said. Indeed, the disease has become a kind of metaphor for women’s vulnerability and for their feminism.

Diane Blum, executive director of Cancer Care, Inc., and a co-founding member of the Board of Sponsors of NBCAM, took note of one of the survey’s most disturbing findings—that almost half the women 65 and over believed they were either at low or no risk for developing breast cancer.

“Older women’s perceptions about risk are particularly alarming when you consider that 77% of breast cancers occur in women over the age of 50,” Ms. Blum said. “The risk of breast cancer increases as women grow older. You don’t outgrow it, so yearly mammograms are a must, especially for women over 65.”

The national study, underwritten by the Board of Sponsors of NBCAM, was conducted by Opinion Research Corporation International, a Princeton, NJ-based research group. Phone interviews were conducted between August and September 1998.