Breast cancer screening in women surviving Hodgkin disease

To inform female Hodgkin disease (HD) survivors, younger than 35 at diagnosis, of their increased risk for breast cancer and encourage them to seek breast cancer screening.

An evidence-based intervention, telephone counseling, was used in a pre-post test design, randomized trial with the control group being offered the intervention following the post-test. Women treated at Stanford University who received thoracic irradiation before age 35, alive and HD-free at last contact, were referred to the project (n = 471). Of 261 eligible women who could be located, 157 completed the pretest and were randomized (60% response rate) and 133 completed the post-test (85% retention rate).

There was a positive intervention effect on mammography maintenance: the odds of being in maintenance at post-test compared with pretest were greater in the intervention group than in the control group [odds ratio (OR) = 3.6]. Women were more likely to be in mammography maintenance at pre- or post-test if at pretest they were married (OR = 5.7), employed (OR = 2.3), more worried about breast cancer (OR = 1.4 per unit of scale), or received an annual physical examination (OR = 2.2). Women under age 40 were much less likely to be in maintenance than were those age 45 and over (age 35-39, OR = 0.2; under age 35, OR = 0.07).

The findings indicate that providing risk information encourages cancer survivors to take health preventive actions. Telephone counseling is a method that can provide risk information and is easily transferable to settings where people seek health information, such as telephone information lines.