Perceived and actual breast cancer risk: Optimistic and pessimistic biases

Celette Sugg Skinner, Matthew W. Kreuter, Sarah Kobrin, Victor J. Strecher

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Perceived risk can influence health behaviors. Studies using various populations and breast cancer risk bias assessment methods have identified both risk over- and underestimation. Among 1803 women in primary care settings, 47 percent were at average epidemiologic risk (Gail-calculated relative risk ± 50 percent of age-adjusted population average) and 55 percent perceived themselves to be at average risk (compared to same-age others) but there were mismatches or 'biases': 31 percent underestimated personal risk; 26 percent overestimated. Multiple logistic regression revealed that smokers were more likely to overestimate risk. Overestimation decreased with more education. Mammography use did not independently predict perception bias but, among never-screened women aged over 40 years, those contemplating mammograms were most likely to overestimate risk; precontemplators were most likely to underestimate. Implications for research and intervention are discussed.

Original languageEnglish (US)
Pages (from-to)181-193
Number of pages13
JournalJournal of Health Psychology
Issue number2
StatePublished - 1998


  • Bias
  • Breast cancer
  • Perception
  • Risk

ASJC Scopus subject areas

  • Applied Psychology


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