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Cancer Risk Reduction Through Education of Adolescents: Development of a Tailored Cancer Risk-Reduction Educational Tool

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Abstract

Growing evidence links adolescent exposures to cancer risk later in life, particularly for common cancers like breast. The adolescent time period is also important for cancer risk reduction as many individual lifestyle behaviors are initiated including smoking and alcohol use. We developed a cancer risk-reduction educational tool tailored for adolescents that focused on five modifiable cancer risk factors. To contextualize risk factors in adolescents’ social and physical environments, the intervention also focused on structural barriers to individual- and community-level change, with an emphasis on environmental justice or the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. The educational tool consisted of a 50-min module that included an introduction to cancer biology including genetic susceptibility and environmental interactions, cancer burden in the local community, and risk reduction strategies. The module also included an interactive activity in which adolescent students identify cancer risk factors and brainstorm strategies for risk reduction at both the individual and community level. We administered the module to 12 classes of over 280 high school and college students in New York City. Cancer risk reduction strategies identified by the students included family- or peer-level strategies such as team physical activity and community-level action including improving parks and taxing sugary foods. We developed a novel and interactive cancer risk-reduction education tool focused on multiple cancers that can be adopted by other communities and educational institutions.

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References

  1. Kehm RD, Yang W, Tehranifar P, Terry MB (2019) 40 years of change in age- and stage-specific cancer incidence rates in US women and men. JNCI Cancer Spectr 3(3):pkz038. https://doi.org/10.1093/jncics/pkz038

    Article  PubMed  PubMed Central  Google Scholar 

  2. Doll R, Peto R (1981) The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 66(6):1191–1308

    Article  CAS  Google Scholar 

  3. Colditz GA, Bohlke K (2014) Priorities for the primary prevention of breast cancer. CA Cancer J Clin 64(3):186–194. https://doi.org/10.3322/caac.21225

    Article  PubMed  Google Scholar 

  4. Blot WJ, Tarone RE (2015) Doll and Peto’s quantitative estimates of cancer risks: holding generally true for 35 years. J Natl Cancer Inst 107(4):djv044. https://doi.org/10.1093/jnci/djv044

    Article  PubMed  Google Scholar 

  5. Maruti SS, Willett WC, Feskanich D, Rosner B, Colditz GA (2008) A prospective study of age-specific physical activity and premenopausal breast cancer. J Natl Cancer Inst 100(10):728–737. https://doi.org/10.1093/jnci/djn135

    Article  PubMed  Google Scholar 

  6. Matthews CE, Shu XO, Jin F, Dai Q, Hebert JR, Ruan ZX, Gao YT, Zheng W (2001) Lifetime physical activity and breast cancer risk in the Shanghai Breast Cancer Study. Br J Cancer 84(7):994–1001. https://doi.org/10.1054/bjoc.2000.1671

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Williams PG, Holmbeck GN, Greenley RN (2002) Adolescent health psychology. J Consult Clin Psychol 70(3):828–842

    Article  Google Scholar 

  8. Kratzke C, Amatya A, Vilchis H (2015) Breast cancer prevention knowledge, beliefs, and information sources between non-Hispanic and Hispanic college women for risk reduction focus. J Community Health 40(1):124–130. https://doi.org/10.1007/s10900-014-9908-9

    Article  PubMed  Google Scholar 

  9. Merten JW, Parker A, Williams A, King JL, Largo-Wight E, Osmani M (2017) Cancer risk factor knowledge among young adults. J Cancer Educ 32(4):865–870. https://doi.org/10.1007/s13187-016-1093-3

    Article  PubMed  Google Scholar 

  10. Zeinomar N, Moslehi R (2013) The effectiveness of a community-based breast cancer education intervention in the New York State Capital Region. J Cancer Educ 28(3):466–473. https://doi.org/10.1007/s13187-013-0488-7

    Article  PubMed  PubMed Central  Google Scholar 

  11. Soto-Perez-de-Celis E, Smith DD, Rojo-Castillo MP, Hurria A, Pavas-Vivas AM, Gitler-Weingarten R, Mohar A, Chavarri-Guerra Y (2017) Implementation of a school-based educational program to increase breast cancer awareness and promote intergenerational transmission of knowledge in a rural Mexican community. Oncologist 22(10):1249–1256. https://doi.org/10.1634/theoncologist.2017-0063

    Article  PubMed  PubMed Central  Google Scholar 

  12. Stölzel F, Seidel N, Uhmann S, Baumann M, Berth H, Hoyer J, Ehninger G (2014) Be smart against cancer! A school-based program covering cancer-related risk behavior. BMC Public Health 14(1):392. https://doi.org/10.1186/1471-2458-14-392

    Article  PubMed  PubMed Central  Google Scholar 

  13. Louis-Nance TR, Flournoy MW, Clinton KS, Hightower K, Sebastian N, Wilkinson LL, Glover SH (2012) The females against cancer educational series: a qualitative evaluation of mother/daughter knowledge and perceptions of human papillomavirus and its related cancers. J Natl Med Assoc 104(3–4):194–198. https://doi.org/10.1016/s0027-9684(15)30137-1

    Article  PubMed  Google Scholar 

  14. Kyle RG, Macmillan I, Rauchhaus P, O’Carroll R, Neal RD, Forbat L, Haw S, Hubbard G (2013) Adolescent Cancer Education (ACE) to increase adolescent and parent cancer awareness and communication: study protocol for a cluster randomised controlled trial. Trials 14:286. https://doi.org/10.1186/1745-6215-14-286

    Article  PubMed  PubMed Central  Google Scholar 

  15. Cunningham-Sabo L, Davis SM (1999) Pathways to Health: a school-based cancer prevention project for Southwestern Native American youth. In: Weiner DE (ed) Preventing and controlling cancer in North America: a cross-cultural perspective. Greenwood Publishing Group

  16. Adamowicz K, Zalewska M, Majkowicz M, Zaucha JM (2015) Evaluation of the impact of different types of health education on the adoption and preservation of prohealth attitudes in preventing cancer in juveniles younger than 18 years. J Cancer Educ 30(3):432–438. https://doi.org/10.1007/s13187-014-0730-y

    Article  PubMed  Google Scholar 

  17. Kerr JC, Valois RF, Farber NB, Vanable PA, Diclemente RJ, Salazar L, Brown LK et al (2013) Effects of promoting health among teens on dietary, physical activity and substance use knowledge and behaviors for African American adolescents. Am J Health Educ 44(4):191–202. https://doi.org/10.1080/19325037.2013.798218

    Article  PubMed  PubMed Central  Google Scholar 

  18. Minkler M, Vásquez VB, Shepard P (2006) Promoting environmental health policy through community based participatory research: a case study from Harlem, New York. J Urban Health 83(1):101–110

    Article  Google Scholar 

  19. Berkey CS, Tamimi RM, Willett WC, Rosner B, Lindsay Frazier A, Colditz GA (2014) Adolescent physical activity and inactivity: a prospective study of risk of benign breast disease in young women. Breast Cancer Res Treat 146(3):611–618. https://doi.org/10.1007/s10549-014-3055-y

    Article  PubMed  PubMed Central  Google Scholar 

  20. Berkey CS, Willett WC, Tamimi RM, Rosner B, Frazier AL, Colditz GA (2013) Vegetable protein and vegetable fat intakes in pre-adolescent and adolescent girls, and risk for benign breast disease in young women. Breast Cancer Res Treat 141(2):299–306. https://doi.org/10.1007/s10549-013-2686-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Lagerros YT, Hsieh SF, Hsieh CC (2004) Physical activity in adolescence and young adulthood and breast cancer risk: a quantitative review. Eur J Cancer Prev 13(1):5–12

    Article  CAS  Google Scholar 

  22. Boeke CE, Eliassen AH, Oh H, Spiegelman D, Willett WC, Tamimi RM (2014) Adolescent physical activity in relation to breast cancer risk. Breast Cancer Res Treat 145(3):715–724. https://doi.org/10.1007/s10549-014-2919-5

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bernstein L, Henderson BE, Hanisch R, Sullivan-Halley J, Ross RK (1994) Physical exercise and reduced risk of breast cancer in young women. J Natl Cancer Inst 86(18):1403–1408

    Article  CAS  Google Scholar 

  24. Fuemmeler BF, Pendzich MK, Tercyak KP (2009) Weight, dietary behavior, and physical activity in childhood and adolescence: implications for adult cancer risk. Obes Facts 2(3):179–186. https://doi.org/10.1159/000220605

    Article  PubMed  PubMed Central  Google Scholar 

  25. King MC, Marks JH, Mandell JB (2003) Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2. Science 302(5645):643–646. https://doi.org/10.1126/science.1088759

    Article  CAS  PubMed  Google Scholar 

  26. Terry MB, Forman MR (2016) Empowering pediatricians to prevent chronic disease across generations. Pediatrics 138(Suppl 1):S92–S94. https://doi.org/10.1542/peds.2015-4268M

    Article  PubMed  Google Scholar 

  27. Mays D, Peshkin BN, Sharff ME, Walker LR, Abraham AA, Hawkins KB, Tercyak KP (2012) Correlates of adherence to a telephone-based multiple health behavior change cancer preventive intervention for teens: the Healthy for Life Program (HELP). Health Educ Behav 39(1):18–26. https://doi.org/10.1177/1090198111404554

    Article  PubMed  Google Scholar 

  28. Nakkash R, Lotfi T, Bteddini D, Haddad P, Najm H, Jbara L, Alaouie H, al Aridi L, al Mulla A, Mahfoud Z, Afifi R (2018) A randomized controlled trial of a theory-informed school-based intervention to prevent waterpipe tobacco smoking: changes in knowledge, attitude, and behaviors in 6th and 7th graders in Lebanon. Int J Environ Res Public Health 15(9). https://doi.org/10.3390/ijerph15091839

  29. Lana A, del Valle MO, López S, Faya-Ornia G, López ML (2013) Study protocol of a randomized controlled trial to improve cancer prevention behaviors in adolescents and adults using a web-based intervention supplemented with SMS. BMC Public Health 13(1):357

    Article  Google Scholar 

  30. Consortium, NYS Cancer (2018) New York State Comprehensive Cancer Control Plan 2018–2023. https://www.health.ny.gov/diseases/cancer/consortium/docs/2018-2023_comp_cancer_control_plan.pdf

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Funding

Funding was provided by the National Cancer Institute (NCI), National Institute for Environmental Health Sciences (NIEHS), National Center for Advancing Translational Sciences (NCATS), and the US Environmental Protection Agency (US EPA): NIEHS/EPA P01ES09600/R82702701, NIEHS/EPA P01ES09600/RD83214101, NIEHS/EPA P01ES09600/RD83450901, NIEHS 1U01ES026122-03, NIEHS R01ES08977, NIEHS R01ES015579, NIDA R01DA027100, NCI 5T32CA009529-25, NCATS TL1TR001875.

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Authors and Affiliations

  1. Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Room 1611, New York, NY, 10032, USA

    Nur Zeinomar, Parisa Tehranifar & Mary Beth Terry

  2. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA

    Amelia Grant-Alfieri, Kimberly R. Burke, Julie B. Herbstman, Rachel L. Miller & Frederica Perera

  3. Columbia Center for Children’s Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA

    Kimberly R. Burke, Julie B. Herbstman & Frederica Perera

  4. WE ACT for Environmental Justice, New York, NY, USA

    Milagros de Hoz, Taylor Morton & Peggy Shepard

  5. Young Survival Coalition, New York, NY, USA

    Desiree A. H. Walker

  6. Division of Pulmonary, Allergy, Critical Care Medicine, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA

    Rachel L. Miller

  7. Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA

    Mary Beth Terry

Authors
  1. Nur Zeinomar
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  2. Amelia Grant-Alfieri
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  4. Milagros de Hoz
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  7. Taylor Morton
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  8. Peggy Shepard
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  10. Rachel L. Miller
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  11. Frederica Perera
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  12. Mary Beth Terry
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Correspondence to Mary Beth Terry.

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Zeinomar, N., Grant-Alfieri, A., Burke, K.R. et al. Cancer Risk Reduction Through Education of Adolescents: Development of a Tailored Cancer Risk-Reduction Educational Tool. J Canc Educ 37, 1220–1227 (2022). https://doi.org/10.1007/s13187-020-01943-7

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