The effect of skepticism of personalized breast cancer risk results on information seeking behavior: A single-arm...

To investigate how expressing skepticism in response to receiving a personalized breast cancer risk estimate is associated with seeking information that is consistent vs. inconsistent with the risk estimate received.

We recruited women from the Dynata internet research panel to complete the Gail model and receive their personalized 10-year risk of developing invasive breast cancer. Participants then completed a survey assessing their skepticism of the results, information seeking behavior, and socio-demographics. "Risk-concordant" information seeking was operationalized as participants clicking a link to receive breast cancer screening information that matched their Gail model risk estimate (e.g., an average-risk woman choosing information for women at average risk). The analytic sample (N = 694) comprised 98% self-reported Black participants and 56% no college degree. The mean age was 56 years.

Overall, 211 (31.0%) of participants agreed with their Gail model results, 346 (50.1%) thought their risk was lower than the Gail model results (i.e., they were underestimators), and 124 (18.2%) thought their risk was higher than the Gail model results (i.e., they were overestimators). Compared to participants who agreed with their estimate, underestimators had lower odds of risk-concordant information seeking, OR= 0.62, 95% CI [0.44, 0.87]. The odds of risk-concordant information seeking did not differ between participants who agreed with their risk estimate and those who were overestimators, OR= 0.85, 95% CI [0.54, 1.32].

Individuals who think their risk is lower than their Gail model estimate may seek health information that is inconsistent with their risk estimate. Seeking health information that differs from an individual's personalized risk estimate may impede informed decision making and successful implementation of risk-stratified screening.