What’s your risk?

Using breast cancer risk as an example, a new survey tested what women would do if offered a hypothetical pill that would cut their risk of breast cancer in half.

Researchers form the University of Michigan Comprehensive Cancer Center surveyed 249 women at random in a hospital cafeteria. They were told their own risk of breast cancer was 6%. Then half were told the average woman’s risk of breast cancer was 12% and the other half were told the average risk was 3%. Both groups were told there was a pill that could reduce their breast cancer risk to 3% but it had side effects including hot flashes in most women and a small risk of cataracts stroke or heart attack. They were then asked if they would take the pill.

The women who were told their risk was above average were more likely to choose the pill than the ones with below average risk. The above average group was also more likely to believe that the pill significantly reduced breast cancer risk even though both groups were told it could cut their risk in half.

No matter what their decision, 62% of the group said the average risk information was helpful in deciding whether to take the pill.

The results disturbed the authors of the survey. “What’s really important is to focus on your risk and the benefits you could get from a treatment,” said author Angela Fagerlin, Ph.D. Fagerlin is a research assistant professor of internal medicine at University of Michigan Medical School and an investigator at the VA Ann Arbor Healthcare System. “Knowing how one’s own risk compared to the average woman’s risk actually changed people’s decisions. It’s very worrisome that this piece of information had an influential impact on a woman’s perceptions of a breast cancer prevention drug.”

Fagerlin believes the study shows that the way women tend to use comparative information is disturbing. “They’re focusing too much on where they stack up against the average and they disregard their own individual risk information,” she said.

In light of these results the authors urge doctors to approach average risk carefully when discussing individual patients’ options

“People should focus on what their own risk is,” said Fagerlin. “The decision should not be influenced by whether their risks or benefits are greater or less than another person.”

SOURCE: Patient Education and Counseling Dec. 2007

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