Abstract
Background
Many people report uncertainty about their cancer risk. We examined whether such uncertainty was related to cancer prevention and detection behaviors.
Methods
National Health Interview Survey data from 2005 to 2010 were analyzed. Participants reported their perceived risk for colorectal and breast cancers. Responses were coded as “valid” (i.e., less/as/more likely than average) or “don’t know.”
Results
In bivariate analyses for both cancer sites and survey years, “don’t know” responders (DKR) engaged in less physical activity than “valid” responders (p < 0.05). DKR had lower mammography adherence than “valid” responders in 2005 and lower colorectal screening adherence in 2010 (p < 0.05). DKR had marginally lower colorectal screening adherence and fruit/vegetable consumption in 2005 (p < 0.06). Multivariable models indicated that the DKR–behavior relationship could be largely accounted for by education.
Conclusion
Interventions that help people understand their cancer risk may provide particular benefit to people with low education and might consequently reduce health disparities.
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References
Conner M, Norman P, eds. Predicting Health Behaviour. Buckingham/Philadelphia: Open University Press; 1995.
Sheeran P, Harris PR, Epton T. Does Heightening Risk Appraisals Change People’s Intentions and Behavior? A Meta-Analysis of Experimental Studies. Psychol Bull. 2013.
Brewer NT, Weinstein ND, Cuite CL, et al. Risk perceptions and their relation to risk behavior. Ann Behav Med. 2004; 27(2): 125-130.
Weinstein ND. Misleading tests of health behavior theories. Ann Behav Med. 2007; 33(1): 1-10.
Peters E, Hibbard J, Slovic P, et al. Numeracy skill and the communication, comprehension, and use of risk-benefit information. Health Aff. 2007; 26(3): 741-748.
Stokols D. Social ecology and behavioral medicine: implications for training, practice and policy. Behav Med. 2000; 26: 129-138.
Krosnick JA. Survey research. Annu Rev Psychol. 1999; 50: 537-567.
Waters EA, Klein WMP, Moser RP, et al. Correlates of unrealistic risk beliefs in a nationally representative sample. J Behav Med. 2011; 34(3): 225-235.
Waters EA, Hay JL, Orom H, et al. “Don’t Know” responses to risk perception measures: implications for underserved populations. Med Decis Mak. 2013; 33(2): 271-281.
Bruine de Bruin W, Fischhoff B, Millstein SG, et al. Verbal and numerical expressions of probability: “It’s a Fifty-Fifty Chance”. Organ Behav Hum Decis Process. 2000; 81(1): 115-131.
Lipkus IM, Rimer BK, Strigo TS. Relationships among objective and subjective risk for breast cancer and mammography stages of change. Cancer Epidemiol Biomarkers Prev. 1996; 5(12): 1005-1011.
Garces-Palacio IC, Scarinci IC. Factors associated with perceived susceptibility to cervical cancer among Latina immigrants in Alabama. Matern Child Health J. 2012; 16(1): 242-248.
Bruine de Bruin W, Carman KG. Measuring Risk Perceptions: What Does the Excessive Use of 50% Mean? Med Decis Mak. 2011.
Hay JL, Orom H, Kiviniemi MT, et al. “I don’t know” my cancer risk: exploring deficits in cancer knowledge and information-seeking skills to explain an often-overlooked participant response. Med Decis Mak. 2015; 35(4): 436-445.
Kiviniemi MT, Orom H, Waters EA, McKillip M, Hay J. Developing awareness of new risks: The case of HIV risk perceptions. under review.
Sabatino SA, White MC, Thompson TD, et al. Centers for disease C, prevention. Cancer screening test use—United States, 2013. MMWR Morb Mortal Wkly Rep. 2015; 64(17): 464-468.
Centers for Disease Control & Prevention. Adult participation in aerobic and muscle-strengthening physical activities--United States, 2011. MMWR Morb Mortal Wkly Rep. 2013; 62(17): 326-330.
Kirkpatrick SI, Dodd KW, Reedy J, et al. Income and race/ethnicity are associated with adherence to food-based dietary guidance among US adults and children. J Acad Nutr Diet. 2012; 112(5): 624.e6-635.e6.
National Center for Health Statistics. Data File Documentation, National Health Interview Survey, 2010 Hyattsville, MD: Division of Health Interview Statistics, National Center for Health Statistics; 2011 [May 23, 2013]. Available from: ftp://ftp.cdc.gov/pub/health_statistics/nchs/dataset_documentation/nhis/2011/srvydesc.pdf.
Colditz GA, Wolin KY, Gehlert S. Applying what we know to accelerate cancer prevention. Sci Transl Med. 2012; 4(127): 127rv4.
American Cancer Society. American Cancer Society Guidelines for the Early Detection of Cancer 2013 [updated May 3, 2013; cited 2013 September 27]. Available from: http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.
MacCallum RC, Zhang S, Preacher KJ, et al. On the practice of dichotomization of quantitative variables. Psychol Methods. 2002; 7(1): 19-40.
Weinstein ND, Sandman PM. The precaution adoption process model. In: Glanz K, Rimer BK, Lewis FM, eds. Health behavior and health education: theory, research, and practice. 3rd ed. San Francisco: Wiley; 2002: 121-143.
Tourangeau R, Rips LJ, Rasinski K. The psychology of survey response. New York: Cambridge University Press; 2000. 401 p.
Brewer NT, Chapman GB, Gibbons FX, et al. A meta-analysis of the relationship between risk perception and health behavior: the example of vaccination. Health Psychol. 2007; 26(2): 136-145.
McCaul KD, Branstetter AD, Schroeder DM, et al. What is the relationship between breast cancer risk and mammography screening? A meta-analytic review. Health Psychol. 1996; 15(6): 423-429.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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The authors declare that they have no conflicts of interest.
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This research was supported by funding from NIH grant R03CA177775 (PI: Waters).
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Waters, E.A., Kiviniemi, M.T., Orom, H. et al. “I don’t know” My Cancer Risk: Implications for Health Behavior Engagement. ann. behav. med. 50, 784–788 (2016). https://doi.org/10.1007/s12160-016-9789-5
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DOI: https://doi.org/10.1007/s12160-016-9789-5