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What Caused this Anyway

Posted 5/5/2014

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  First, a disclaimer: Yes, I know the title should be: "What Caused this Anyway?", but our system won't accept punctuation--therefore, no question mark. My apologies.

  The question is an important one and absolutely one of the things that every women diagnosed with breast cancer wonders and agonizes about. Did I somehow bring this on myself? Is it because I ate too much fast food or had wine every night or didn't control my stress or grew up around heavy use of pesticides? If you never remember one other thing that I have written about, please remember this: Breast cancer was not caused by anything you did or did not do. You are not responsible."

  Even as I repeat that mantra over and over to newly diagnosed women, I listen to them worry about causality. One of my favorite examples is a woman who is convinced that her breast cancer was caused by the dog stepping on her breast. Not true. Cancer of any kind is an exceptionally complicated cellular process that scientists are just beginning to understand. You/we did not do it to ourselves.

  This is a really interesting article from Cancer Causes Control that compares the causality attributed by woman to that understood by doctors and scientists. I give you the abstract. Since I am unable to send a link, please email me (hhill@bidmc.harvard.edu) if you want the whole article, and I will forward it to you.

What causes breast cancer? A systematic review of causal attributions among breast cancer survivors and how these compare to expert-endorsed risk factors
Jo Anne Dumalaon-Canaria • Amanda D. Hutchinson •
Ivanka Prichard •

Abstract
Purpose The aim of this paper was to review published
research that analyzed causal attributions for breast cancer
among women previously diagnosed with breast cancer.
These attributions were compared with risk factors identified
by published scientific evidence in order to determine
the level of agreement between cancer survivors’ attributions
and expert opinion.
Methods A comprehensive search for articles, published
between 1982 and 2012, reporting studies on causal attributions
for breast cancer among patients and survivors was
undertaken. Of 5,135 potentially relevant articles, 22
studies met the inclusion criteria. Two additional articles
were sourced from reference lists of included studies.
Results Results indicated a consistent belief among survivors
that their own breast cancer could be attributed to
family history, environmental factors, stress, fate, or
chance. Lifestyle factors were less frequently identified,
despite expert health information highlighting the importance
of these factors in controlling and modifying cancer
risk. This review demonstrated that misperceptions about
the contribution of modifiable lifestyle factors to the risk of
breast cancer have remained largely unchanged over the
past 30 years.
Conclusions The findings of this review indicate that
beliefs about the causes of breast cancer among affected
women are not always consistent with the judgment of
experts. Breast cancer survivors did not regularly identify
causal factors supported by expert consensus such as age,
physical inactivity, breast density, alcohol consumption,
and reproductive history. Further research examining psychological
predictors of attributions and the impact of
cancer prevention messages on adjustment

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