Women over-estimate breast cancer risk

Kathy

Yes, but here’s another statistic:
Breast cancer is the leading cause of death for women ages 15-54. Not heart disease. Not lung cancer. Not traffic accidents. Breast cancer.
Here’s another statistic: few cancer treatments are as mutilating as breast cancer. Okay, I made this one up, but here’s my point: the numbers you cite make it sound like women are hysterical about this issue without cause. In fact, women are not hysterical, but we are concerned, and with good reason. We “youngsters” are tired of being told how “survivable” breast cancer is, especially when it means we lose the one feature that is valued by mates above all: tits. Show me the numbers on how many 30-year old mastectomy patients go on to get married, have kids, and lead full lives, and I’ll show you calmer women. Second, the risk of breast cancer may be low for younger women, but it’s a deadlier disease, and it’s not preventable through lifestyle choices the way (we are told, at any rate) that lung cancer and heart disease are.
And there’s an experiential side to breast cancer risk that outweighs the statistics for most women. To understand, try this little experiment: show up at work one day and say “ayyyyy, my best friend just got diagnosed with breast cancer!” I predict the following: if you work in an office of at least 50 people, at least 10 will come forward and say “yeah, my mother too…. my sister… both of my aunts… my cousin…don’t worry honey, I survived it and she will too.” This experiential factor speaks more loudly than all the epidemiology in the world to a whole lot of folks. It may be irrelevant to individual risk, but it happens, it makes an impression, and it sure doesn’t feel like “1.4%”.
One final point: a lot of women (but not all) understand that there’s a huge difference between a 1.4% age-adjusted population risk, and an utterly unknown and unknowable (except for BRCA patients) individual risk. Again, if we had a reasonable model for this, it would make a difference, but we don’t. So any given woman feels either lucky or doomed, depending on how much he/she has brushed up against breast cancer lately; and there are millions of breast cancer patients out there to brush up against.
Does that help you understand a little better why women worry about this disease in what seems a disproportionate-to-the-epidemiology degree? On a related note, I often hear doctors complain that heart disease is a far greater risk factor but women don’t worry enough about it. This is what I’d love to tell them: age-adjust those numbers, and the answer will stare you in the face.