Abstract
BackgroundIt is estimated that nearly 600,000 cancer cases in the UK could have been avoided in the past five years if people had healthier lifestyles. A number of theories of behaviour change suggest that before people will change health behaviours, they must accept that a risk applies to them. This study aimed to explore the views of the public on receiving personalised cancer risk information and the potential for that information to motivate behaviour change.MethodsWe conducted 27 interviews with members of the public (mean age 49 ± 23 years). Each participant completed a questionnaire to allow calculation of their risk of developing the most common cancers (10 for women, 8 for men). During the interviews we presented their risk using a web-based tool developed for the study and discussions covered their views on receiving that information. Each interview was audio-recorded and then analysed using thematic analysis.ResultsParticipants generally viewed the concept of personalised cancer risk positively. The first reaction of almost all when presented with their 10-year risk of an individual cancer without any further context was that it was low and not concerning. Views on what constituted a high risk ranged widely, from 0.5 to 60%. All felt seeing the impact of changes in lifestyle was helpful. For some this led to intentions to change behaviour, but reductions in risk were not always motivating as the risks were considered low and differences small.ConclusionsProvision of personalised cancer risk was well received and may be a useful addition to other cancer prevention initiatives. Further work is needed in particular to develop ways to present cancer risk that reflect the general perception of what constitutes a risk high enough to motivate behaviour change and help patients contextualise a less well known health risk by providing a frame of reference.
Highlights
It is estimated that nearly 600,000 cancer cases in the UK could have been avoided in the past five years if people had healthier lifestyles
We know from evidence, that only 3% of the general public are aware that being overweight can increase their risk of cancer, less than a third are aware that physical activity could help reduce risk [2,3,4,5], and one in seven people believe that lifetime risk of cancer is unmodifiable [6]
Previous research has confirmed that providing cancer risk information to individuals can improve accuracy of risk perception [9, 22, 23] and enhance response efficacy [24] and intention to have cancer screening [25, 26]
Summary
It is estimated that nearly 600,000 cancer cases in the UK could have been avoided in the past five years if people had healthier lifestyles. A number of behaviour change theories, including Protection Motivation Theory [10] and the Extended Parallel Process Model [11], suggest that providing individuals with their estimated risk of developing cancer and demonstrating the impact of lifestyle change on that future risk may motivate change at an individual level through increases in accuracy of risk perception and response efficacy [12]. This could complement wider collective approaches to shifting population distributions of behaviour and risk factors. Unlike similar risk tools for other conditions, such as QRisk2® [31] for cardiovascular disease, these tools are rarely used in routine healthcare settings [32].It is not clear how best to incorporate risk assessment into practice to maximise benefits whilst minimising harms
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