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dc.contributor.authorKarliner, Leah S.
dc.contributor.authorNapoles-Springer, Anna
dc.contributor.authorKerlikowske, Karla
dc.contributor.authorHaas, Jennifer S.
dc.contributor.authorGregorich, Steven E.
dc.contributor.authorKaplan, Celia Patricia
dc.date.accessioned2011-05-12T03:54:49Z
dc.date.issued2007
dc.identifier.citationKarliner, Leah S., Anna Napoles-Springer, Karla Kerlikowske, Jennifer S. Haas, Steven E. Gregorich, and Celia Patricia Kaplan. 2007. Missed opportunities: family history and behavioral risk factors in breast cancer risk assessment among a multiethnic group of women. Journal of General Internal Medicine 22(3): 308-314.en_US
dc.identifier.issn0884-8734en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:4888660
dc.description.abstractBackground: Clinician’s knowledge of a woman’s cancer family history (CFH) and counseling about health-related behaviors (HRB) is necessary for appropriate breast cancer care. Objective: To evaluate whether clinicians solicit CFH and counsel women on HRB; to assess relationship of well visits and patient risk perception or worry with clinician’s behavior. Design: Cross-sectional population-based telephone survey. Participants: Multiethnic sample; 1,700 women from San Francisco Mammography Registry with a screening mammogram in 2001–2002. Measurements: Predictors: well visit in prior year, self-perception of 10-year breast cancer risk, worry scale. Outcomes: Patient report of clinician asking about CFH in prior year, or ever counseling about HRB in relation to breast cancer risk. Multivariate models included age, ethnicity, education, language of interview, insurance/mammography facility, well visit, ever having a breast biopsy/follow-up mammography, Gail-Model risk, Jewish heritage, and body mass index. Results: 58% reported clinicians asked about CFH; 33% reported clinicians ever discussed HRB. In multivariate analysis, regardless of actual risk, perceived risk, or level of worry, having had a well visit in prior year was associated with increased odds (OR = 2.3; 95% CI 1.6, 3.3) that a clinician asked about CFH. Regardless of actual risk of breast cancer, a higher level of worry (OR = 1.9; 95% CI 1.4, 2.6) was associated with increased odds that a clinician ever discussed HRB. Conclusions: Clinicians are missing opportunities to elicit family cancer histories and counsel about health-related behaviors and breast cancer risk. Preventive health visits offer opportunities for clinicians to address family history, risk behaviors, and patients’ worries about breast cancer.en_US
dc.language.isoen_USen_US
dc.publisherSpringer-Verlagen_US
dc.relation.isversionofdoi:10.1007/s11606-006-0087-yen_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1824768/pdf/en_US
dash.licenseLAA
dc.subjectfamily historyen_US
dc.subjectbreast canceren_US
dc.subjectrisk assessmenten_US
dc.subjectmultiethnicen_US
dc.titleMissed opportunities: family history and behavioral risk factors in breast cancer risk assessment among a multiethnic group of womenen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalJournal of General Internal Medicineen_US
dash.depositing.authorHaas, Jennifer S.
dc.date.available2011-05-12T03:54:49Z
dash.affiliation.otherSPH^Society Human Development and Healthen_US
dash.affiliation.otherHMS^Medicine-Brigham and Women's Hospitalen_US
dc.identifier.doi10.1007/s11606-006-0087-y*
dash.contributor.affiliatedHaas, Jennifer


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