Association Between Cancer Risk Perception and Screening Behavior Among Diverse Women

Abstract

Background: We measured the perception of breast, cervical, and colon cancer risks and screening in diverse women to examine the association between risk perception and screening behavior. Methods: Cross-sectional telephone and in-person interviews of women aged 50 to 80 years were conducted in English, Spanish, or Chinese. The women were recruited from primary care practices in San Francisco, California (academic general internal medicine, family medicine, women's health practices, a community-based clinic in Chinatown, and the Community Health Network Clinics, which is affiliated with the San Francisco Department of Public Health), with at least 1 visit within the previous 2 years. Perceived personal risk for each cancer was measured on a word scale (no risk to very high risk) and compared with self-reported screening behavior by ethnicity. Results: A total of 1160 women participated: 338 (29%) were White, 167 (14%) were African American, 239 (21%) were Latina, and 416 (36%) were Asian. The average participant was 61 years old and a high school graduate; 18% had a personal history of cancer, and 42% had a family history of cancer. The perceived lifetime risk of cancer varied by ethnicity. Compared with White women, Latinas had a higher perceived risk for cervical cancer (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.8-4.6) and colon cancer (OR, 3.0; 95% CI, 1.8-5.0) after multivariate adjustment, and Asians had a lower perceived risk for cervical cancer (OR, 0.6; 95% CI, 0.4-0.9) and colon cancer (OR, 0.6; 95% CI, 0.3-0.9). Higher colon cancer risk perception was associated with having undergone colonoscopy within 10 years (OR, 2.8; 95% CI, 1.4-5.4). Conclusions: Risk perception was significantly associated with colon cancer screening behavior (P = .001). Evaluation of patients' perceived risk of cancer may be useful to clinicians who are recommending screening tests.

Weight Status and Perception of Colorectal Cancer Risk

“…19 Perhaps black women perceive a higher CRC risk because they more often see the diagnosis made in family members. Kim et al 20 found that family history was a predictor of perceived risk for CRC among a group of diverse women. The opposite trend, although not statistically significant, is seen in black men, in which obese black men see themselves as at decreased risk for cancer compared with nonobese black men.…”

Colorectal Cancer Screening: What Do Women From Diverse Ethnic Groups Want?

“…However, Asians stated that they would be less likely than Whites to obtain colonoscopy after hearing the risks and benefits. While we do not know the reasons for these differences, these race/ethnic differences may be partly due to the difference in risk perception between these groups, 5 and being Latino or Asian was also an independent predictor of willingness and intention to undergo CRC screening.…”

“…Risk perception is different than actual risk; thus, a person who perceives herself to be at increased risk may or may not actually be at increased risk. We had previously shown that perceived risk was significantly associated with higher use of CRC screening tests, 5 but these women uniformly overestimated their numerical risk of CRC compared to population rates. Because of the importance of risk perception as a motivator of behavior, future research should address whether targeting perceived risk may result in changes in CRC screening behavior and clarify the use of different measures to assess perceived risk in diverse populations.…”

“…Previous studies have shown that personal risk perception is an important factor in motivating individuals to obtain cancer screening, although the optimal measure of risk perception is not clear. 5,19 In a recent study of risk perception and colorectal cancer screening with 1,628 persons (51 % women, 75 % White), participants read messages about the importance of screening to reduce the risk of cancer. Perceived risk was evaluated with four measures: absolute numerical scale, absolute verbal scale, a comparative measure and a "feelings-of-risk" measure.…”

“…This paper only concerns the questions related to willingness to be screened for CRC, and results from other analyses have been published elsewhere. [5][6][7][8][9] Interviews took place between October 2003 and December 2005.…”