Colon Cancer Risk Perception Associated With Screening Behavior

Women’s perception of their cancer risk appears to vary by race and may affect how likely they are to undergo screenings, particularly for colon cancer, according to a report in the April 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.


Risk of developing and dying from cancer varies by race and ethnicity among women, according to background information in the article. For example, African Americans have the highest risk of developing colon cancer and dying from breast or cervical cancer, while Latinas have higher rates of illness and death from cervical cancer but a lower risk of breast and colon cancer. “Communication of cancer risk to ethnically diverse populations of women has the potential to affect screening behavior,” the authors write. “With increasing epidemiological information that quantifies the risks and benefits of early detection and prevention strategies, women’s perceived risk for cancer may become a more important factor in the decision to undergo screening.”


Sue E. Kim, Ph.D., M.P.H., of the University of California, San Francisco, and colleagues conducted in-person and telephone interviews regarding breast, cervical and colon cancer with 1,160 women age 50 to 80 (average age 61). “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,” the authors write.


Of the women, 338 (29 percent) were white, 167 (14 percent) were African American, 239 (21 percent) were Latina and 416 (36 percent) were Asian. Perceived risk for each cancer varied by ethnicity; “we found that Asian women had the lowest perceived risk for breast, cervical and colon cancers and that Latinas had the highest perceived risk,” the authors write. “This perceived risk was associated with obtaining self-reported cancer screening tests after other factors were accounted for.”


Almost half of the participants (572) reported either a personal or family history of cancer. This type of history was associated with a higher risk perception for breast and colon cancer. Women with a family history of cancer were almost twice as likely to have undergone colonoscopy as women without a family history.


“Evaluation of perceived risk of cancer may be useful to clinicians who are recommending screening tests and incorporating an intervention to help diverse populations understand risk and interpret medical data,” the authors conclude.


Arch Intern Med. 2008; 168[7]:728-734.