Perceived risk of breast cancer: influence of heuristic thinking

The purpose of this study was to examine the influence of heuristic reasoning on women's perceived risk for developing breast cancer, and to test for an expected bias in the direction of optimism that is predicted by recent research on human cognition.

In total, 770 women recruited in community settings were surveyed regarding cancer screening behavior and their perceived risk of developing breast cancer.

Most women perceived their risk of breast cancer to be lower than that of other women (3:1), confirming the expected bias toward optimism, and this finding was not attributable to the personality trait of optimism. Women following mammography guidelines showed greater optimism that their risk was low. Cancer knowledge and education diminished unwarranted optimism. Women with a history of benign breast disease, with a female relative with breast cancer, or both overestimated their risk. All findings suggest that heuristic thinking is being used to estimate personal cancer risk.

Clinicians should expect women to be optimistic about their personal risk of developing breast cancer. As a result, women may put off breast cancer screening or delay the evaluation of breast symptoms that may signal breast cancer. Helping women to understand their relative risk is an essential part of a health promotion visit.