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Discovering the causes of cancer and the means of prevention

Short-Form Breast Cancer Risk – Women’s Health Questionnaire

The following questionnaire segment contains questions that have been used as part of DCEG or other epidemiologic studies. This segment has not necessarily been reviewed or analyzed by the Technical Evaluation Committee. Please view it as a starting point that can be adapted or improved upon as appropriate. Learn more about DCEG Questionnaire Development Resources.

Questionnaire Topic: 

Breast Cancer Risk Factors 

Study Title: 

Women's Health Study 



Principal Investigator(s): 

L. Brinton 

Type of Questionnaire: 


Last Year of Data Collection: 


Short/Long Form: 

Short Form 


Brinton LA, Brown SL, Colton T, et al. Characteristics of a population of women with breasts implants compared with women seeking other types of plastic surgery. Plastic & Reconstructive Surgery. 2000;105(3):919-27. 

Download Breast_Cancer_Risk_Womens_Health_questionnaire_ShortForm (Word, 25 KB)

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Learn more about DCEG Questionnaire Development Resources