The Risk Conundrum

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Tara Parker-Pope's "Well" column in yesterday's New York Times discusses in some depth the conundrum of why women with elevated risk of breast cancer are reluctant to take tamoxifen or raloxifene for 'chemoprevention' of breast cancer. These drugs have been proven to reduce the risk of breast cancer (and osteoporosis). She writes, "While [the risks of side effects] are not to be taken lightly, neither are the risks of failing to use tamoxifen; its benefits for breast and bone are substantial. Yet virtually every woman in the study said she would be unlikely to take the drug. Just 6 percent said they would consider it after talking to their doctors, and only 1 percent reported actually filling a prescription for it."

"This is very interesting," says ACSH's Dr. Elizabeth Whelan. "It's so counterintuitive. We're always told how much women fear breast cancer, so you would think they'd do anything to avoid it."

"There's a psychological factor at play here called the omission heuristic," says ACSH's Dr. Gilbert Ross. "People would rather not do something that has a small risk now even though it could prevent a much greater risk in the future. If I were to tell a woman that she can reduce her risk of breast cancer by 50 percent by taking this pill, but there is 10 percent chance of side effects, an overwhelming majority will elect not to take their chances with it."

For more information, see ACSH's publication on reducing breast cancer risk with drugs.