Local public awareness of hereditary breast and ovarian cancer among Hong Kong Chinese tertiary students

Abstract

Background: Breast cancer is the most common malignancy in Hong Kong women. When breast cancer occurs due to a hereditary cause, women tend to have breast cancer at a younger age. Hereditary Breast and Ovarian Cancer (HBOC) related genes including BRCA1 was found in celebrity Angelina Jolie, who announced to the public that she had undertaken a risk-reducing/prophylactic bilateral mastectomy. Given the intense media attention, the public interest and awareness of HBOC was aroused, which could affect individuals’ preventive health behaviours. Since an increasing number of cases of breast cancer were occurring at early age onset, HBOC and the genetic testing may be relevant to many with breast cancer history. However, the general public in Hong Kong may lack the genetic literacy. This study investigates whether participants’ awareness, knowledge and/or perceived risk of the disease is associated with their health attitude and/or personal/family cancer history.

Methods: The current study employed a cross sectional design to examine tertiary students’ genetic knowledge of HBOC. A total of 495 participants from the higher education institutions in Hong Kong were recruited.

Results: There was a significant difference between participants with family cancer history and those without in the general understanding on HBOC, indicating that those with relatives diagnosed with cancer in the past were more knowledgeable than those without. A significant difference was found for gender in both the self-perceived breast cancer inheritance risk and family breast cancer risk perception, indicating that females thought that they were more likely to inherit breast cancer in the future than did males, and participants with family cancer history were more likely to think that they will get hereditary breast cancer in their life than those without. A significant difference was also found in the perceived risk of family getting breast cancer between the above 2 groups, indicating that after controlling for the gender difference, participants with family diagnosed with cancer in the past was more likely to think that their family is at higher risk of developing breast cancer than those without family cancer history

Discussion: This study showed that young adults did not know the topic well. Nevertheless, Medical Science students had better awareness and genetic knowledge on the topic. Females were shown to have a higher estimated probability of inheriting breast cancer than the male participants. After controlling for the effects of gender difference and knowledge of genetic testing, participants with one or more first or second-degree family members with cancer history were more aware of the genetic issue than those without. Their self-perceived breast cancer risk of inheritance and perceived family of breast cancer risk were also relatively higher than those without a family cancer history. This showed family cancer experiences may have profound influence on breast cancer risk perceptions and the level of anxiety this brings about. Thus, it is important to help the public to better distinguish the risks of the disease. Results of this study could be used to guide the development of public education materials and public awareness campaigns.