JMIR Publications

ABSTRACT

Background:

Women in a breast cancer prevention trial had provided breast cancer risk perception and general anxiety pre-COVID-19 and were surveyed up to four times about COVID-19 and breast cancer risk perception, general anxiety and missed medical care early in COVID-19 (May to December 2020).

Objective:

Whether COVID-19 is associated with change in risk perception about other health conditions is unknown.

Methods:

We quantified the relationship between perceived risk of COVID-19 and change in perceived breast cancer risk compared to pre-pandemic and hypothesized that women who perceived greater COVID-19 risk would evidence increased perceived breast cancer risk and this risk would relate to increased anxiety and missed cancer screening.

Results:

Among 13,002 women who completed a survey, compared to pre-COVID-19, anxiety was higher during COVID-19 (mean T-score 53.5 wave 1 v 49.7 pre-COVID-19, p<0.001) and directly related to perceived COVID-19 risk. Despite no overall difference in breast cancer risk perception (mean 32.5% wave 1 v 32.5% pre-COVID-19, p=0.93), there was a direct relationship between change in perceived breast cancer risk with COVID-19 risk perception, ranging in survey wave 4 from a 2.4% decrease in breast cancer risk perception for those with very low COVID-19 risk perception to an increase of 3.4% for women with moderate to very high COVID-19 risk perception. This was not explained by change in anxiety or missed cancer screening.

Conclusions:

This natural experiment suggests that a global threat such as COVID-19 may have implications beyond the pandemic. Preventive health behaviors related to perceived risk may need attention as COVID-19 becomes endemic.