Psychological Aspects of Cancer Prevention and Early Detection Among Women. In: Andersen BL, editor. Women with Cancer. New York: Springer; 1986. pp. 93-137. [DOI: 10.1007/978-1-4613-8671-1_3]

A Cross Sectional Survey on Breast Self Examination Practice, Utilization of Breast Professional Examination, Mammography and Associated Factors in Romagna, Italy

In 1988, a cross-sectional survey was carried out in the Romagna region (Italy) to evaluate the association between knowledge of breast pathophysiology and preventive attitudes and screening tests practice for breast cancer. A self-administered questionnaire was distributed to a sample of asymptomatic women aged 20–64 years living in the city of Faenza (Northern Italy). Of the 657 responders, 58 % reported that they practiced breast self-examination; 55% had had a professional breast examination, and only 9 % had had a mammogram as a screening test. Logistic regression analysis (including variables such as age, education, employment) was performed to explore the relationship between screening tests practice and factors associated with their use. Breast self-examination practice (n = 590) was associated with preventive attitudes (aOR = 1.67, 95°/o CI = 1.09–2.53) and with a positive history of breast disease (aOR = 3.48, 95 % CI = 1.72–7.04). Professional breast examination (n = 480) was related to preventive attitudes (aOR = 2.37, 95 % CI = 1.51–3.71), knowledge of breast pathophysiology (aOR = 2.07, 95 % CI = 1.31–3.28), and use of oral contraceptives (aOR = 1.81, 95% CI = 1.12–2.91). Mammography use (n = 540) was associated with preventive attitudes (aOR = 3.08, 95 % CI = 1.40–6.76). The results show an inadequate utilization of screening tests in our population. Breast self-examination is strongly related to a positive history of breast disease, and this could reflect the lack of health educational programs aimed at the general population.

Psychosocial oncology research. Where we have been, where we are going, and why we will not get there

Quality of life, symptom management, and social support are the traditional foci for the practice of psychosocial oncology and clinical research into the behavioral and psychologic aspects of cancer. The current paradigm for research in this area primarily assesses patient responses to cancer related stressors and the means of ameliorating the negative aspects of those responses. However, clinically meaningful interventions have been the exception, rather than the rule. The authors think that the central event initiating a stressful response is the interaction between the patient and physician conveying the diagnosis, prognosis, or treatment plan. The authors think addressing the initial event in a cascade of responses is an important prerequisite for progress in this area.