Abstract
Few trial data are available concerning the impact of personalised cancer risk information on behaviour. This study assessed the short-term effects of providing personalised cancer risk information on cancer risk beliefs and self-reported behaviour. We randomised 1018 participants, recruited through the online platform Prolific, to either a control group receiving cancer-specific lifestyle advice or one of three intervention groups receiving their computed 10-year risk of developing one of the five most common preventable cancers either as a bar chart, a pictograph or a qualitative scale alongside the same lifestyle advice. The primary outcome was change from baseline in computed risk relative to an individual with a recommended lifestyle (RRI)11RRI – estimated risk relative to an individual of the same age and sex with a recommended lifestyle. at three months. Secondary outcomes included: health-related behaviours, risk perception, anxiety, worry, intention to change behaviour, and a newly defined concept, risk conviction. After three months there were no between-group differences in change in RRI (p = 0.71). At immediate follow-up, accuracy of absolute risk perception (p < 0.001), absolute and comparative risk conviction (p < 0.001) and intention to increase fruit and vegetables (p = 0.026) and decrease processed meat (p = 0.033) were higher in all intervention groups relative to the control group. The increases in accuracy and conviction were only seen in individuals with high numeracy and low baseline conviction, respectively. These findings suggest that personalised cancer risk information alongside lifestyle advice can increase short-term risk accuracy and conviction without increasing worry or anxiety but has little impact on health-related behaviour.Trial registration: ISRCTN17450583. Registered 30 January 2018.
Highlights
40% of cancer cases can be attributed to lifestyle factors such as smoking, alcohol intake, diet, physical activity levels and sun protection[1]
When accompanied by information about these risk factors and the benefits of change, personalised cancer risk information may improve the accuracy of risk perception and reduce overestimation and increase response efficacy, in turn reducing maladaptive responses and motivating behaviour change (Figure 1)
Our findings suggest that the provision of personalised cancer risk information alongside lifestyle advice can increase short term risk accuracy, conviction about one’s risk, and intention to change behaviour more than lifestyle advice alone
Summary
40% of cancer cases can be attributed to lifestyle factors such as smoking, alcohol intake, diet, physical activity levels and sun protection[1]. Originally developed to understand responses to fear appeals, two widely used theories of behaviour change[8,9], can help describe how such overestimation and lack of response efficacy, or the perceived effectiveness of recommended actions, might be associated with maladaptive responses such as feelings of fatalism or hopelessness[10,11,12] and decreased motivation to change behaviour. Individuals who overestimate their risk of developing cancer and are unaware of the benefits of changes in their lifestyle, may feel it is almost useless to try to stay healthy and so have low motivation to change. When accompanied by information about these risk factors and the benefits of change, personalised cancer risk information may improve the accuracy of risk perception and reduce overestimation and increase response efficacy, in turn reducing maladaptive responses and motivating behaviour change (Figure 1)
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