College Women and Breast Cancer: Knowledge, Behavior, and Beliefs regarding Risk Reduction

By Burak, Lydia; Boone, Barbara | American Journal of Health Education, July-August 2008 | Go to article overview

College Women and Breast Cancer: Knowledge, Behavior, and Beliefs regarding Risk Reduction


Burak, Lydia, Boone, Barbara, American Journal of Health Education


ABSTRACT

Background: Although breast cancer prevention should begin in youth, many young women are not aware of the modifiable lifestyle risk factors for the disease. Purpose: The purposes of this study were to examine the breast cancer-related knowledge, behaviors, and beliefs of young women; to determine whether knowledge about lifestyle risks was related to risk-reducing behaviors; and to determine whether value expectancy constructs could predict risk-reducing behaviors. Method: Surveys assessing knowledge, behaviors, beliefs, and demographics were administered to 522 college women. Results: The majority of the participants lacked knowledge about the lifestyle risk factors for breast cancer, and knowledge and beliefs were unrelated to their behaviors. Discussion: The results of the study have implications for health educators, health care providers, and researchers who provide young women with the information and skills to engage in behaviors that may protect them against breast cancer. Translation to Health Education Practice: Young women need to understand that engaging in certain behaviors can lower their risk of breast cancer. Health educators need to incorporate breast cancer risk reduction into their educational efforts with young women.

BACKGROUND

Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer deaths for women in the U.S. In 2007, approximately 178,480 women were projected to be diagnosed with breast cancer, and 40,460 of them were projected to die of the disease. (1) Over her lifetime, a woman has a 1 in 8 chance of developing breast cancer. (1)

Breast cancer incidence rates are higher for postmenopausal women than premenopausal women. Postmenopausal women have anywhere from a 1 in 25 to a 1 in 15 chance of being diagnosed, while women under 40 have a 1 in 210 chance. (1) More than 11,000 annual cases of breast cancer are estimated to occur in women under 40 (2); 1,225 women under 40 died from breast cancer in 2004. (1) Surveillance Epidemiology and End Results (SEER) data collected over 25 years from 73,367 women found that although premenopausal women had a comparatively smaller breast cancer incidence rate than postmenopausal women, younger women were often diagnosed with a more aggressive form of the cancer and had higher mortality and recurrence rates. (3) In addition to battling a life-threatening disease and undergoing aggressive and invasive treatments, young women of childbearing age who develop breast cancer face more challenges and anxieties because of the potential side effects of treatment on their reproductive systems. (4,5)

Cancer is considered a continuum along which interruptions can take place at any point, from susceptibility to clinical manifestation. (6) One way to interrupt the continuum of breast cancer is to help young women acquire knowledge about risk factors and become motivated to reduce these factors in the face of a disease that poses an increasing threat as one ages.

RISK FACTORS

Most risk factors associated with breast cancer are very complex, and some of them are not well understood. Knowledge of some is backed by strong scientific evidence while studies of others have yielded conflicting results. Risk factors can be organized into two main groups: genetic, inherited, and environmental factors that are usually non-modifiable, and lifestyle factors that can be modified in most cases. Women have no control over established risk factors such as gender, age, race, genetic makeup, family history, and environmental exposures to certain carcinogenic contaminants. They do, however, have control over risk factors such as reproductive choices, body weight, nutritional choices, physical activity, and alcohol consumption.

The American Cancer Society (7) identifies parity and age at first birth, breastfeeding, oral contraception, hormone replacement therapy (HRT), obesity and high-fat diets, activity and exercise level, and alcohol consumption as potentially modifiable risk factors for breast cancer. …

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