Women's decisions regarding tamoxifen for breast cancer prevention: Responses to a tailored decision aid
Tamoxifen reduces primary breast cancer incidence, yet causes serious side
effects. To date, few women with increased breast cancer risk have elected to
use tamoxifen for chemoprevention. The objective of the study was to determine
women’s knowledge of and attitudes toward tamoxifen following exposure to a
tailored decision aid (DA). A total of 632 women with a 5-year risk of breast
cancer ≥1.66% (Mean = 2.56, range = 1.7–17.3) were recruited from two healthcare
organizations. Participants viewed an online DA that informed them about their
5-year risk of breast cancer and presented individually tailored content
depicting the risks/benefits of tamoxifen prophylaxis. Outcome measures included
behavioral intentions (to seek additional information about tamoxifen, to talk
to a physician about tamoxifen, and to take tamoxifen); knowledge; and perceived
risks and benefits of tamoxifen. After viewing the DA, 29% of participants said
they intended to seek more information or talk to their doctor about tamoxifen,
and only 6% believed they would take tamoxifen. Knowledge was considerable, with
63% of women answering at least 5 of 6 knowledge questions correctly.
Participants were concerned about the risks of tamoxifen, and many believed that
the benefits of tamoxifen did not outweigh the risks. This study is the largest
to date to test women’s preferences for taking tamoxifen and one of the largest
to have tested the impact of a tailored DA. After viewing the DA, women
demonstrated good understanding of tamoxifen’s risks and benefits, but most were
not interested in taking tamoxifen for breast cancer chemoprevention.
Related Topics:
Decision aids,
Cancer - breast
Keywords:
Decision Aids, Patient Education, Tamoxifen, Breast Cancer Prevention
Citation
(view)
Fagerlin A, Zikmund-Fisher BJ, Hayes DF, Zweig SC, Smith DM, Nair V, Derry HA, McClure JB, Greene SM, Stark AT, Alford SH, Lantz PM. Women's decisions regarding tamoxifen for breast cancer prevention: Responses to a tailored decision aid. Breast Cancer Research and Treatment
2010;119:613-620.
Angela Fagerlin, PhD
Angie Fagerlin studied psychology and literature at Hope College and received her PhD in experimental (cognitive) psychology at Kent State University. Her primary research focus is testing methods for communicating the risks and benefits of treatment to patients (e.g., in decision aids). Her other...
Brian Zikmund-Fisher, PhD
Brian J. Zikmund-Fisher is an Assistant Professor in the Department of Health Behavior and Health Education, University of Michigan School of Public Health, as well as a Research Assistant Professor in the Division of General Internal Medicine, University of Michigan Medical School. He is...
Dylan Smith, PhD
Dylan Smith studied social psychology at Arizona State University, where his work focused on interpersonal and intergroup relations and evolutionary psychology. His current research seeks to translate theoretical and methodological advances in the behavioral sciences to the study of health-related...