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Women's Interest in Chemoprevention for Breast Cancer
Lori A. Bastian, MD, MPH;
Isaac M. Lipkus, PhD;
Maggie N. Kuchibhatla, PhD;
Haoling Holly Weng, MHS;
Susan Halabi, PhD;
Paula D. Ryan, MD, PhD;
Celette Sugg Skinner, PhD;
Barbara K. Rimer, DrPH
Arch Intern Med. 2001;161:1639-1644.
Background Chemoprevention is the use of pharmacologic or natural agents to inhibit
the development of cancer. Tamoxifen citrate is the only approved chemopreventive
agent for breast cancer. We sought to determine whether women are interested
in taking a drug to prevent breast cancer and to assess the relationship between
objective and subjective breast cancer risk and interest in chemoprevention.
Methods We conducted telephone interviews (November 3, 1997, to May 6, 1998)
among a community sample of women aged 40 to 45 and 50 to 55 years enrolled
in a randomized controlled trial to evaluate the efficacy of a tailored mammography
decision aid. Objective breast cancer risk was measured using the 5-year Gail
score. Subjective breast cancer risk was measured using perceptions of absolute
risk, perceptions of comparative risk, and worry about getting breast cancer.
At 12-month follow-up (November 2, 1998, to July 20, 1999), we measured interest
in taking a drug to prevent breast cancer.
Results Among the 1273 women surveyed, 23% were interested in taking a drug
to prevent breast cancer; 8% were potentially eligible for tamoxifen therapy
(5-year Gail score  1.66%). Eligibility for chemoprevention, based on the
5-year Gail score, was not associated with interest in taking a drug to prevent
breast cancer. Women who were worried about breast cancer were 3 times more
likely to be interested in taking a drug to prevent breast cancer than those
who were not worried.
Conclusion Women's interest in chemoprevention might arise more from worries about
getting breast cancer than from their objective risk factors.
From Cancer Prevention, Detection, and Control Research (Drs Bastian,
Lipkus, Kuchibhatla, Halabi, Skinner, and Rimer) and the Departments of Internal
Medicine (Drs Bastian and Ryan), Family and Community Medicine (Drs Lipkus,
Kuchibhatla, Halabi, and Rimer), and Surgery (Dr Skinner), Duke University
Medical Center, Durham, NC; The Center for Health Services Research in Primary
Care, Durham Veterans Affairs Medical Center (Dr Bastian and Ms Weng); and
Division of Cancer Control and Population Sciences, National Cancer Institute,
Bethesda, Md (Dr Rimer).
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