ASPO Abstracts
Associations between breast cancer risk estimation and modifiable health behaviors in the Bright Pink Assess Your Risk population
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2021
Abstract Body:
Purpose: Breast cancer risk assessment tools identify women at elevated risk due to family history or
genetic susceptibility and account for self-reported modifiable health behaviors. Bright Pink, a
Chicago-based nonprofit, developed the Assess Your Risk (AYR) tool using National Cancer Center
Network criteria to estimate breast cancer risk through a user-friendly, online quiz. This study aims to
examine associations between breast cancer risk assessment and health behaviors in the Bright Pink
population.
Methods: We included women (aged 21+) who completed the Bright Pink AYR versions 1.0 and 2.0
(2016-2018). We examined the associations between AYR breast cancer risk category (average,
increased, or high) and health behaviors, including exercise (150 min/week), current smoking status,
daily alcohol consumption (0, 1, or 2+ drinks/day), and body mass index (BMI). We also examined
effect modification by age group and confounding by factors known to impact breast cancer risk.
Results: The analysis examined 464,796 women, with slightly over half (53%) in the 21-30 age group.
Compared to women in the AYR tool average risk category for breast cancer, women in the high-risk
category had significantly greater odds of engaging in recommended exercise levels (Odds Ratio [OR]
1.23, 95% Confidence Interval [CI] 1.12-1.35) or 2+ alcoholic drinks/day (OR 1.32, 95% CI 1.18-1.48),
but lower odds of BMI ≥30 kg/m2 (OR 0.87, 95% CI 0.77-0.97). Women in the AYR tool increased risk
category had greater odds of reporting current smoking (OR 1.21, 95% CI 1.19-1.24), 2+ drinks/day
(OR 1.09, 95% CI (1.07-1.11), and a BMI ≥30 kg/m2 (OR 1.03, 95% CI 1.01-1.05) compared to the
average risk category. Moreover, we identified statistically significant interactions by age group, with
older women were less likely to exercise and drink >1 drink per day but more likely to have BMI ≥25
(p-trend by age<0.001; p-interaction<0.001 for all).
Conclusions: Self-reported health behaviors differ by AYR breast cancer risk assessment categories.
Knowledge of elevated breast cancer risk may lead to improved health behaviors among high-risk
women, especially among the younger age groups. Future interventions must incorporate age-specific
education on modifiable health behaviors into risk assessment tools.
Keywords: breast cancer, health behaviors, risk assessment