Canadian Women’s Attitudes Toward Receiving Personalized Breast Cancer Risk Information: Insights From the PERSPECTIVE I&I Project

BACKGROUND: Risk-stratified breast cancer screening has been proposed as an alternative to the age-based approach currently used by most screening programs. This study, part of the Canadian PERSPECTIVE I&I project, examined perceived advantages and disadvantages of learning your breast cancer risk category and associated screening plans. METHOD: Women aged 40 to 69 from Ontario and Quebec (N = 3319) had multifactorial risk assessments using the CanRisk tool. Risk categories (average [78.9%], higher than average [16.4%], high [4.6%]) were communicated along with screening plans. Participants completed questionnaires on attitudes toward learning their risk before, at the time of, and 1 year later risk communication. Participant characteristics associated with these attitudes were assessed using multinomial logistic regression. RESULTS: At the time of risk communication, most participants (72.9%) perceived ``Easing worry'' as an advantage of learning their risk. However, participants at higher risk were more likely to report that it did not ease their worry. Visible minority participants (OR = 1.86, 95% CI, 1.16, 2.98) and those with lower education attainment were more likely to view "complicated information" as a disadvantage (College/Apprenticeship/Trades: OR = 1.54, 95% CI, 1.24, 1.92; High School or below: OR = 1.77, 95% CI, 1.29, 2.42). Ontario participants were more likely to view risk communication as "information I do not want to know" (OR = 0.44, 95% CI, 0.32, 0.59) compared to Quebec participants. CONCLUSION: Most women responded positively to learning their breast cancer risk category and screening plan. Successful implementation of risk-stratified screening will require clear communication, healthcare provider support, and adaptation to regional resources.