Cancer Risk Perception Research Articles

Value Attribution in the Decision to Use of Whole Body MRI for Early Cancer Diagnosis.

This study aimed to identify the main factors that asymptomatic individuals considered when deciding to undergo self-referred Whole-body MRI (WB-MRI) for early cancer diagnosis and the subjective values attributed to each mentioned factor in a Decision tree analysis. Personal characteristics such as risk perception and personality were investigated as possible factors affecting value attribution. Seventy-four volunteers (mean age 56.4; male = 47) filled a simplified decision tree by expressing the expected factors and related subjective values associated with two screening options for early cancer diagnosis (standard procedures vs. WB-MRI+standard procedures) while waiting for a WB-MRI examination. Questionnaires on risk perception and personality traits were also administered. Expected factors were summarized in 5 clusters: diagnostic certainty, psychological well-being, safety, test validity and time/cost. Test validity and time/cost were evaluated as potential losses in both procedures. Diagnostic Certainty and safety were evaluated as losses in standard screening, and as an advantage when considering WB-MRI+standard screening. Forty-five percent of participants considered WB-MRI+standard screening as beneficial for their psychological well-being. Finally, personal absolute and comparative risk to get cancer was associated with a positive value attribution to WB-MRI (p < 0.05). Our results showed the addition of WB-MRI to be generally considered a good option to increase individuals’ perceptions of diagnostic certainty and the safety of the exam, and to increase psychological well-being. The positive value of such a screening option increased with the individual’s cancer risk perception.

P348 Perception of cancer risk in inflammatory bowel disease-associated dysplasia and management practice is influenced by colonoscopy experience and workplace affiliation: results of an international clinician survey

Abstract Background A successful inflammatory bowel disease (IBD) surveillance cancer preventative programme requires effective action to be taken when dysplasia is detected. This is the first international cross-sectional study to evaluate current clinician understanding of IBD dysplasia risk, their management practice and adherence to the most recent international guidelines introduced since 2015. Methods A 15-item online survey was disseminated to IBD gastroenterologist and colorectal surgeon members of the British Society of Gastroenterology in June 2019 and the European Crohn’s and Colitis Organisation in February 2020. Results 294 clinicians (93.5% gastroenterologists) from 60 countries responded. A significant proportion indicated not having access to high definition chromoendoscopy IBD surveillance (23%) in their endoscopy units. University hospitals were more likely than non-academic workplaces to provide second expert histopathologist review (67% vs. 46%; p=0.002) and formal multidisciplinary team meeting discussion (73% vs. 52%; p=0.001) of dysplasia cases. Most respondents would advocate endoscopic resection of all visible dysplasia and would refer to a regional specialist therapeutic endoscopist if needed (70%). However, perceptions of 5-year cancer risk associated with endoscopically unresectable low-grade dysplasia (LGD) varied between 0 – 100% (median 20% for visible LGD and median 25% for invisible LGD). Although most (98.4%) would advise a colectomy for endoscopically unresectable visible high-grade dysplasia (HGD), only 34.4% would also advise a colectomy for unresectable visible LGD. Working at a non-academic hospital was predictive of a lower perceived cancer risk with HGD [OR 0.4 (95% CI 0.23-0.95)] and unresectable LGD. Working in a private clinic predicted surveillance preference over colectomy to manage invisible LGD [OR 9.4 (95% CI 1.19-74.1)] and multifocal LGD. Greater surveillance colonoscopy experience predicted a lower preference for continued surveillance over colectomy for invisible LGD [OR 0.41 (95% CI 0.20-0.84)]. Conclusion This study of mainly European gastroenterologists with a sub-specialist interest in IBD has revealed wide variations in colorectal cancer risk perceptions and dysplasia management practices. Clinicians with less IBD surveillance colonoscopy experience and from non-academic centres appeared to have lower cancer risk perceptions and were less likely to advocate colectomy over continued surveillance for high-risk LGD. This study suggests that further education is required to align current management practice with clinical guidelines.

Psychosocial determinants of quit motivation in older smokers from deprived backgrounds: a cross-sectional survey

ObjectivesTo identify psychosocial determinants of quit motivation in older deprived smokers. The evidence may be used to optimise smoking cessation interventions for the target population.DesignCross-sectional survey using online recruitment methods...

260 Sun protection attitudes and behaviors among minority groups in a low socioeconomic community

Background: Although skin cancer is less common among minority groups, they often present at later stages and have worse outcomes. Literature on this disparity is limited. Objective: To evaluate the attitudes influencing sun protective behaviors, skin cancer risk perception, and dermatologist access among an underserved, racially and ethnically diverse community. Methods: A cross-sectional survey of adult patients at five student-run, free primary care clinics in Sacramento, California. Results: 390 surveys were collected with a response rate of 86.4%. Overall, respondents did not use sunscreen, rarely sunburned, were unsure or perceived themselves at low risk for skin cancer and reported limited access to dermatologists. Compared to Whites, Latinos were likely to believe it was not worth getting sunburned to be tan (OR = 24.43, 95% CI: 9.37 to 63.3, P < 0.001). Whites were more likely than Asians (OR = 3.69, 95% CI: 1.50 to 9. 11, P = 0.004) and Latinos (OR = 4.83, 95% CI: 1.83 to 12.8, P = 0.001) to perceive having access to a dermatologist. Conclusions: Ethnic groups differ in their knowledge of sun protection and self-perceived skin cancer risk. The Latino community showed discrepancies between sun protection knowledge and practices, serving as a possible interventional target.

Perceived Breast Cancer Risk among Female Undergraduate Students in Ghana: A Cross-Sectional Study.

Background While breast cancer accounts for the highest mortality among women across the globe, little is known about its perceived risks among them. We examined the perceived risk of breast cancer among undergraduate female university students in Ghana. Methods This was a cross-sectional survey of 358 undergraduate female students at the University of Health and Allied Sciences, Ghana. Descriptive and inferential statistics comprising frequencies, percentages, chi-square, and binary logistic regression analyses were used in analysing the data collected. All analyses were done using STATA Version 13.1. Results Seventy-three percent were aware of breast cancer and 45.2% out of this did not perceive themselves to be at risk of breast cancer. Academic year (p=0.02), school (p=0.01), knowledge of someone with breast cancer (p < 0.001), family history of breast cancer (p < 0.001), current use of oral pills/injectable contraception (p=0.03), history of breast cancer screening (p < 0.001), and intention to perform breast self-examination (p < 0.001) were the risk factors of breast cancer risk perception. Students without a family history of breast cancer were 90% less likely to perceive breast cancer risk (AOR = 0.10, 95% CI = 0.04–0.29) compared with those having a family history of breast cancer. Students who had never screened for breast cancer were also 62% less likely to perceive that they were at risk of breast cancer (AOR = 0.10, 95% CI = 0.04–0.29) compared with those who had ever screened for breast cancer. Conclusion This study showed that female university students tend to estimate their breast cancer risk based on their experience of breast cancer. Students who have ever screened for breast cancer and those with the intention to perform breast self-examination in the future are more likely to perceive themselves as being at risk and thus take action to avoid getting breast cancer.

Cultural Differences in Cancer Information Acquisition: Cancer Risk Perceptions, Fatalistic Beliefs, and Worry as Predictors of Cancer Information Seeking and Avoidance in the U.S. and China

ABSTRACT Cancer is one of the most common causes of death in China and the United States. Past studies found that cancer risk perceptions, fatalistic beliefs, and worry were prominent predictors of health-related behaviors. Perceived cancer risks, fatalistic beliefs, and worry were associated with cancer information acquisition in the United States. However, little is known about whether these factors played comparable roles in China. This study investigates the psychological antecedents of cancer information acquisition using data from Health Information National Trends Surveys (HINTS) in both countries. Results showed that cancer worry was negatively related to cancer information avoidance in the U.S. but positively related to information avoidance in China. Also, whereas cancer fatalistic beliefs were negatively associated with cancer information seeking in the U.S., the relationships between fatalistic beliefs and cancer information seeking exhibited more complex patterns in China. Implications for cancer communication in different cultures are discussed.

Accuracy of self-perceived risk perception of breast cancer development in Iranian women

BackgroundThe accuracy of subjective risk perception is a matter of concern in breast cancer development. The objective of this study was to evaluate the accuracy of self-perceived risk assessment of breast cancer development and compared to actual risk in Iranian women.MethodsThe demographic, clinical, and reproductive characteristics of 800 women aged 35–85 years were collected with an in-person interview. The self-perceived risk and the actual risk were assessed using the visual analog scale (VAS) and he Gail model respectively. Gail’s cutoff of 1.66% risk was used to categorize the estimated 5-year actual risk as low/average risk (< 1.66%) and high risk (≥ 1.66). In low/average risk, if the self-perceived risk > actual risk, then individuals were considered as overestimating. Similarly, in high-risk women, if the perceived risk < actual risk, then, the subjects were labeled as under-estimate; otherwise, it was labeled as accurate. The Kappa statistics were used to determine the agreement between self-perceived risk and actual risk. ROC analysis was applied to determine the accuracy of self-perceived risk in the prediction of actual risk.ResultsThe perceived risk was significantly higher than actual risk (p = 0.001, 0.01 for 5-year and lifetime risk respectively). Both in low and high-risk groups about half of the women over-estimate and underestimate the risk by subjective risk perception. For a 5-year risk assessment, there was no agreement between perceived risk and actual risk (Kappa = 0.00, p = 0.98) but a very low agreement between them in lifetime risk assessment (Kappa = 0.09, p = 0.005). The performance of accuracy of risk perception versus actual risk was very low (AUC = 0.53, 95% CI 0.44–0.61 and AUC = 0.58, 95% CI 0.54–0.62 for the 5-year risk and lifetime risk respectively).ConclusionThe clinical performance of risk perception based on VAS is very poor. Thus, the efforts of the public health education program should focus on the correct perception of breast cancer risk among Iranian women.

Risk Perception Among a Lung Cancer Screening Population

A successful lung cancer screening program requires a patient cohort at sufficient risk of developing cancer who are willing to participate. Among other factors, a patient's lung cancer risk perception may inform their attitudes toward screening and smoking cessation programs. This study analyzed data from the Pan-Canadian Early Detection of Lung Cancer (PanCan) Study to address the following questions: Which factors are associated with the perception of lung cancer risk? Is there an association between risk perception for lung cancer and actual calculated risk? Is there an association between risk perception for lung cancer and the intent to quit smoking? Are there potential targets for lung cancer screening awareness? The PanCan study recruited current or former smokers aged 50 to 75 years who had at least a 2%risk of developing lung cancer over 6 years to undergo low-dose screening CT. Risk perception and worry about lung cancer were captured on a baseline questionnaire. Cumulative logistic regression analysis was used to assess the relationship between baseline risk variables and both lung cancer risk perception and worry. Among the 2,514 individuals analyzed, a higher perceived risk of lung cancer was positively associated with calculated risk (P= .032). Younger age, being a former smoker, respiratory symptoms, lower FEV1, COPD, and a family history of lung cancer were associated with higher perceived risk. Conversely, a consistent relationship between calculated risk and worry was not identified. There was a positive association between risk perception and lung cancer worry and reported intent to quit smoking. Individuals' lung cancer risk perception correlated positively with calculated risk in a screening population. Promotion of screening programs may benefit from focusing on factors associated with higher risk perception; conversely, harnessing worry seemingly holds less value.

ES13.03 Managing the Psychological Needs of Patients in a Screening Service

Psychological considerations within the realm of lung cancer screening are broad and span a number of areas. The aim of this talk is to give a brief overview of some of these areas. Firstly, an understanding of psychosocial factors can help program leaders develop campaigns to promote services and better target specific populations that demonstrate risk (Irwin et al., 2019; Montano et al., 1997). There are specific psychosocial factors including anxiety, fatalism, and concerns regarding stigma that impact the willingness of individuals and specific populations to accept screening (Quaife et al., 2017). Strategies for targeting these concerns include directly addressing these areas with patients, and coaching providers and medical team members to intervene. Secondly, tobacco/smoking cessation is vital to decreasing risk of lung cancer as well as a host of other illnesses and all cause mortality (Li et al., 2020). Psychology has an important role in engaging patients with quitting services and providing support and programming during quitting (Iaccarino et al., 2019). Motivational interviewing strategies have been shown to be particularly important in generating treatment engagement around addiction services in general, and tobacco cessation in particular (Miller & Rollnick, 2013). Efforts to convince patients to engage often backfire, while approaching individuals with curiosity and allowing space for patients to explore their own motivation to quit generate increased motivation. It is optimal that all program staff are aware of motivational interviewing principles and work together to create an atmosphere of partnership, acceptance, and compassion. Once tobacco/smoking cessation treatment has been accepted, matching individuals with modalities that fit their preferences, and are also most likely to generate successful outcomes, becomes important (Carter-Harris et al., 2018). Having recommendations for diverse modalities including in-person services, telephone services, text support, and apps allows patients to engage in ways that can minimize drop out from treatment. Providing a combination of medication and support resources as well as services that can provide support throughout the timeframe of quitting have also been shown to generate the greatest success in quitting. Finally, as with screening for any potentially serious diagnosis, patients can respond with significant distress at any point in the process (Byrne et al., 2008). In particular, waiting for results, receiving significant findings, or receiving inconclusive results are particularly risky times (Dunn et al., 2017). It is important for program staff to be aware of psychological signs indicating a need for additional services, and what types of services are best suited to address these concerns. Cognitive behavioral and mindfulness-based interventions have demonstrated significant positive outcomes for lessening distress in cancer patients following diagnosis and during treatment (Carlson, 2017). These treatments lessen distress by assisting patients in changing behaviors, thoughts, and their relationship to both cognitive and affective responses to stress. Byrne, M. M., Weissfeld, J., & Roberts, M. S. (2008). Anxiety, fear of cancer, and perceived risk of cancer following lung cancer screening. Medical Decision Making 28(Nov-Dec), 917-925. https://doi.org/10.1177/0272989X08322013 Carlson, M. (2017). CBT for psychological well-being in cancer: A skills training manual integrating DBT, ACT, behavioral activation and motivational interviewing (1st ed.). John Wiley & Sons Ltd. https://doi.org/10.1002/9781119161370 Carter-Harris, L., Shwindt, R., Bakoyannis, G., Ceppa, D. P. (2018). Current smokers’ preferences for receiving cessation information in a lung cancer screening setting. Journal of Cancer Education 33(5), 1120-1125. https://doi.org/10.1007/s13187-017-1222-7 Dunn, C. E., Edwards, A., Carter, B., Field, J. K., Brain, K., & Lifford, K. J. (2017). The role of screening expectations in modifying short-term psychological responses to low-dose computed tomography lung cancer screening among high risk individuals. Patient Education and Counseling 100, 1572-1579. https://dx.doi.org/10.1016.j.pec.2017.02.024 Iaccarino, J. M., Duran, C., Slatore, C. G., Weiner, R. S., & Kathuria, H. (2019). Combining smoking cessation intervention with LDCT lung cancer screening: A systematic review. Preventive Medicine 121, 24-32. https://doi.org/10.1016/j.ypmed.2019.02.016 Irwin, K. E., Stefens, E. B., Yoon, Y., Flores, E., J., Knight, H. P., Pirl, W. F., Freudenreich, O., Henderson, D. C., & Park, E. R. (2019). Lung cancer screening eligibility, risk perceptions, and clinician delivery of tobacco cessation among patients with schizophrenia. Psychiatric Services 70, 927-934. https://doi.org/10.1176/appi.ps.201900044 Li, J., Chung, S., Martinez, M. C., & Luft, H. S. (2020). Smoking-cessation interventions after lung cancer screening guidelines change. American Journal of Preventive Medicine 59(1), 88-97. https://doi.org/10.1016/j.amepre.2020.01.031 Miller, W. R., & Rollnick, S. (2013). Motivational interviewing (3rd ed.). The Guilford Press. Montano, D. E., Kasprzyk, D., Taplin, S. H. (1997). The theory of reasoned action and the theory of planned behavior. In K. Glanz, F. M. Lewis, & B. K. Rimer (Eds.), Health behavior and health education: Theory, research, and practice (pp. 85-112). Jossey-Bass Inc. Quaife, S. L., Marlow, L. A. V., McEwen, A., Janes, S. M., & Wardle, J. (2017). Attitudes towards lung cancer screening in socioeconomically deprived and heavy smoking communities: informing screening communication. Health Expectations 20, 563-573. https://doi.org/10.1111/hex.12481

Predictor of Breast Self-Examination and Breast Cancer Risk Perception among Female Students of WCU, Using Health Belief Model

Background: Breast Self-Examination (BSE) is a primary screening technique to detect breast abnormalities. By performing regular breast self-examination, women would become familiar with their breasts condition so as to enable them to detect any changes from time to time. BSE must be routinely performed by an individual female from young. This is because breast cancer can be developed at the very age of twenty. This study was aimed to assess the predictor of breast self-examination and breast cancer risk perception among female students of WCU, by using health belief model. Methods: Cross-sectional study was conducted in Wachamo University female students, Hossana, Ethiopia. Data collection tool is an anonymous valid and reliable questionnaire, which acquired information about the factors affecting predictor of breast self-examination and breast cancer risk perception. The data was entered in Epi data V-3.1 and analysed using SPSS version 21. Binary logistic regression analysis was also employed to examine association between dependent and independent variables. P-value of <0.05 was considered as cut off point for significance. Results: A total of 441 study subjects participated in this study making response rate of 99.3 % with mean age of the study population was 21 years. 98 % of the participants were single and 38% were protestant religion followers. Most of them 92.3% ever heard about breast cancer and 43.3% of the participants ever heard about BSE. The main source of information on breast cancer and BSE were media 74.1%. The overall knowledge of the students about breast self-examination was 61%. Good knowledge on BSE and breast cancer risk perception 5.01[2.13, 11.18], facing of breast discomfort 3.04[1.07, 9], family history of breast cancer 6.32[1.08, 14.95], high perceived susceptibility 2.5[1.2, 6.09], high perceived severity were 3.3[1.01, 8.65]) were independent predictors of breast self-examination among female Wachemo University students. Conclusions and Recommendation: In this study breast self-examination among female Wachemo University students so comes to be 39.2% which is lower than other studies even if there is some similar figures were there. Intervenes should have to be needed by designing and carrying out to enhance the skills and efficacy of the female students regarding self-examinations of their breasts. Governmental organization should have to scale up breast screening service as one of the packages from youth friendly service because it’s long-term consequence serious.

Men in rural Nigeria have a poor perception of prostate cancer risk; Hence they seldom seek screening.

The study aimed to investigate the behavioral and social factors that underlie the risk perception and screening behavior of prostate cancer (PCa) among rural men in Southwest Nigeria. The study adopted a descriptive cross-sectional design. To investigate the behavioral and social factors associated with men's screening behavior in rural communities, the study utilized an interviewer-administered questionnaire. A sample of 384 men who lived in six rural communities across Southwest Nigeria participated in the study. Constructs of the Health Belief Model provided theoretical framing. Key variables were the demographics, screening behavior, knowledge of PCa, and perception of PCa risk. Data analysis tools were descriptive (simple percentages) and multiple regression at p<0.05. About 49.7% were age 31-40, most of the men in the rural communities (64.1%) did not have more than secondary school education, and about 48.7% owned their businesses. Exactly 56% earned less than 18,000 per month; 65.6% were Christians, and the majority (90.6%) were married, with most (60.2%) not having more than four children (≤4 children). Knowledge of PCa has a significant but weak relationship with PCa screening behavior (p=0.02). Age (β=0.014), religion (β=0.052), and income (β=0.010)/(β=0.011) had predicted risk perception. Only income (β=0.038) significantly influenced screening behavior. There is a need to improve PCa awareness and knowledge to address risk perception fears and encourage increased screening behavior among men in rural areas.

Culture and perceptions on cancer risk and prevention, information access, and source credibility: a qualitative interview study in Chinese adults

We aimed to explore cancer risk and prevention perceptions, information access, and source credibility evaluation about cancer risk and prevention in adults in an Eastern cultural context (China). We conducted 32 in-depth interviews in two Chinese cities: Shanghai and Wuhan, from September 2016 to January 2017. Though not fully supported by scientific evidence, our findings showed that stress was among the top five concerns in the participants’ perceptions of cancer risk and prevention. Obesity and infectious agents, significant cancer risks for Chinese populations, did not receive so much attention among the participants. Principles of Eastern culture, such as change, contradiction, and holism, were reflected in the participants’ interpretations and understandings of cancer risk and prevention. Beliefs in fate or destiny, as associated with Eastern culture, were also apparent in the strongly fatalistic views towards cancer prevention of some participants. Individual responsibility for cancer risk, rather than collective responsibility (such as government or society), was emphasised by participants. Except for personal social networks, the information channels where the participants frequently accessed cancer risk and prevention information (the media) were completely different from the information channels they trusted (healthcare system). Our findings provide useful references for cancer risk and prevention communication and education in China.

Guidelines on Pancreatic Cystic Neoplasms: Major Inconsistencies With Available Evidence and Clinical Practice— Results From an International Survey

Guidelines on Pancreatic Cystic Neoplasms: Major Inconsistencies With Available Evidence and Clinical Practice— Results From an International Survey

Abstract PS8-05: Randomized controlled trial of decision support tools for patients and providers to increase breast cancer chemoprevention

Abstract Background: Breast cancer chemoprevention with selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs) have been shown in randomized controlled trials to reduce breast cancer incidence by 50-65% among high-risk women. However, chemoprevention is still underutilized with fewer than 5% of high-risk women offered chemoprevention agreeing to take the medications. Reasons for low chemoprevention uptake include inadequate knowledge about chemoprevention among patients and healthcare providers, concerns about side effects, competing comorbidities, and time constraints during the clinical encounter. To address these barriers to chemoprevention uptake, we developed decision support tools for patients and providers. Methods: We conducted a randomized controlled trial of standard educational materials alone or combined with web-based decision support tools, RealRisks and BNAV, among 300 high-risk women and 50 healthcare providers, respectively. Patient eligibility criteria included: 1) women, age 35-75 years; 2) high-risk for breast cancer, defined as a 5-year invasive breast cancer risk ≥1.67% according to the Gail model or history of lobular carcinoma in situ (LCIS); 3) no prior use of a SERM or AI; 4) No personal history of breast cancer; 5) Access to the internet. Providers included primary care providers, such as internists, family practitioners, gynecologists, and nurse practitioners, and specialists, such as breast surgeons and medical oncologists. The RealRisks decision aid (DA) is available in English and Spanish and includes interactive modules to communicate personalized breast cancer risk and the risks and benefits of chemoprevention. The BNAV tool includes self-paced learning modules on breast cancer risk factors and chemoprevention and was made available to all providers through the electronic health record (EHR) dashboard. The primary endpoint was chemoprevention uptake at 6 months as assessed via the EHR. Secondary outcomes included validated measures of perceived breast cancer risk, breast cancer worry, chemoprevention knowledge, self-efficacy, decision conflict, chemoprevention attitudes, intention, and informed choice, which were administered to patients at baseline, 1 month, and 6 months after randomization. Results: Among 282 evaluable high-risk women enrolled from November 2016 to March 2020, mean age was 57 years (SD, 9.9), including 59% white, 14% black, 21% Hispanic, and 6% other. Mean 5-year invasive breast cancer risk was 2.98% (SD, 1.42), including 67% of women with benign breast disease and 64% with a first-degree family history of breast cancer. Comparing the intervention and control arms at 1 month, there were significant differences among high-risk women in accurate breast cancer risk perceptions (56% vs. 39%, p=0.017), adequate chemoprevention knowledge (49% vs. 27%, p&amp;lt;0.001), informed choice (41% vs. 23%, p=0.003), and mean decision conflict (34.0 vs. 47.0, p&amp;lt;0.001). There were no significant differences between the two groups in other patient-reported outcomes. Among patients who completed their 6-month follow-up, only 2.3% of high-risk women in the intervention arm and 3.8% in the control arm initiated a SERM or AI for breast cancer chemoprevention. Conclusions: With short-term follow-up, exposure to our decision support tools was associated with improvement in decision antecedents (accurate breast cancer risk perceptions, adequate chemoprevention knowledge) and decision quality (increased informed choice, reduced decision conflict). However, actual chemoprevention uptake in both arms remained low at less than 5%. Future research should focus on targeting high-risk women with LCIS or atypical hyperplasia and better incorporating decision support into clinic workflow through EHRs and patient portals. Citation Format: Katherine D Crew, Gauri Bhatkhande, Thomas Silverman, Tarsha Jones, Jennie Mata, Ashlee Guzman, Ting He, Jill Dimond, Rita Kukafka. Randomized controlled trial of decision support tools for patients and providers to increase breast cancer chemoprevention [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS8-05.

Relationship of patient-centered communication and cancer risk information avoidance: A social cognitive perspective

ObjectiveWe examined the relationship between patient-centered communication and cancer risk information avoidance and estimated the mediating role of self-efficacy in this relationship. MethodsUsing nationally representative cross-sectional data from the U.S. Health Information National Trends Survey (N = 2033), this study aims to provide a comprehensive understanding of the relationship between patient-centered communication and cancer risk information avoidance via correlation analysis, stepwise regression models, and mediation analysis. ResultsPatient-centered communication was significantly negatively associated with cancer risk information avoidance (β= −0.09, p < 0.01) after controlling for gender, income, education, and cancer risk perception. Self-efficacy fully mediated the relationship of patient-centered communication with cancer risk information avoidance. ConclusionPatient-centered communication can improve patients’ self-efficacy, thereby preventing them from avoiding cancer risk information. Practice implicationsThe negative relationship between patient-centered communication and cancer risk information avoidance substantiates that improving patient-centered communication is a promising approach to support caregivers in their activities, reduce patients’ subjective cancer burden, and even improve their health. To address cancer-related issues, policymakers can consider interventions from the external environment and internal personal cognition perspectives.

Influence of lived experience on risk perception among women who received a breast cancer polygenic risk score: 'Another piece of the pie'.

Polygenic risk scores (PRS) are personalized assessments of disease risk based on the cumulative effect of common low-risk genetic variants. PRS have been shown to accurately predict women's breast cancer risk and are likely to be incorporated into personalized breast cancer risk management programs. However, there are few studies investigating the individual impact of receiving a breast cancer PRS. Existing studies have not demonstrated significant changes in perceived risk or risk management behaviors after receipt of polygenic risk information. The aim of this qualitative study was to explore how women with a family history of breast cancer construct breast cancer risk perceptions after receipt of a breast cancer PRS. Unaffected women with a family history of breast cancer who had not previously received genetic counseling regarding their breast cancer risk were invited to participate in this study. In-depth, semi-structured interviews were conducted with 20 women who attended a familial cancer clinic in the Australian states of Victoria and Tasmania. Data were analyzed using an inductive thematic approach. Women's lived experience played a significant role in the construction and maintenance of their breast cancer risk perception. Women's pre-existing risk perceptions were informed by their family history and their knowledge that breast cancer is a multifactorial disease. Knowing that breast cancer is a multifactorial disease enabled most women to integrate genetic information with their pre-existing notions of risk. Women reported that the information they received was consistent with their existing notions of personal risk and screening advice. Therefore, the PRS did not lead to a change in perceived risk or risk management behaviors for most women. The results of this study provide insight into how polygenic risk information is integrated with pre-existing notions of risk, which will inform its implementation into clinical practice.

Lung Cancer Risk Perception Among Older Smokers; a Cross-sectional Study

Background: Lung cancer is one of the deadliest cancers around the world. Also, scientific evidence proves the considerably lower lung cancer risk perceptions of smokers compared to non-smokers. Objectives: This study aimed at assessing the risk perception of smokers about their risk to contract lung cancer and their perceptions about lung cancer survival. Methods: In this cross-sectional study, the data were collected from 215 smokers in Tabriz, Iran, between April 2019 and July 2019. The data collection tool was designed, using validated questionnaires and contained questions on the perceived risk of smokers to develop lung cancer and their perception of lung cancer survival. A general linear model was conducted to model the relationship of risk perception with underlying predictors considering a significance level of 0.1. Results: The results of modeling indicated that perceived susceptibility (P-Sus) was negatively related to “years smoked” in simple regression (B = -0.035, P = 0.069) and multiple regression (B = -0.069, P = 0.007). P-Sus was also negatively related to the variable “age” in the age category of 45 to 50 years (B = -1.981, P = 0.046). Moreover, perceived severity (P-Sev) was negatively related to the variable “sex” (B = -1.037, P = 0.068). The results of the Spearman correlation indicated significant and direct correlations between “quitting intention” and P-Sus (r = 0.296, P &lt; 0.001), P-Sev (r = 0.162, P = 0.009). Conclusions: Lung cancer risk perception of participants was moderately above the average and significant correlations were observed between “quitting intention” and “P-Sus” and “P-Sev” and “Risk Perception score”. This could be utilized in developing educational programs to promote awareness about lung cancer, especially for smokers.

Identification of factors that influence the decision to take chemoprevention in patients with a significant family history of breast cancer: results from a patient questionnaire survey.

Chemoprevention reduces the risk of developing breast cancer in women with increased family history (FH) risk of breast cancer. However, chemoprevention uptake remains low and the reasons for this remain unclear. Patients with moderate- or high-risk FH of breast cancer were counselled about chemoprevention (n = 1620; September 2015 to July 2018) in breast clinics. A postal questionnaire survey was subsequently sent to these patients in order to explore the potential factors influencing their decision on chemoprevention uptake. 518 patients (32%) completed the questionnaire survey; 75% were pre-menopausal and the majority had moderate as opposed to high-risk FH (87.5% vs. 12.5%). Breast cancer chemoprevention uptake rate was 10.8% (56/518). The identified incentives were more commonly stated for patients who took chemoprevention when compared to those who refused chemoprevention. The commonest incentives were breast cancer prevention (89.3% vs. 61.7%; p = 0.001), belief in the effectiveness of chemoprevention (76.8% vs. 63.4%; p = 0.048), and personal perception of breast cancer risk (67.9% vs. 45.5%; p = 0.002). Similarly, the identified barriers were more commonly stated for patients who refused chemoprevention when compared to those who took chemoprevention. The commonest barriers were side effects (79.4% vs. 55.4%; p = 0.001) and lack of information (53% vs. 28.6%; p = 0.001). Despite its proven efficacy, chemoprevention uptake in patients with a significant FH of breast cancer remains low. We have identified important factors which influence the patient's decision making. Future clinic consultations should focus on exploring these factors to aid patient decision making.

Health information-seeking behaviors among high-perceived cancer risk individuals who experienced hearing loss: An exploratory study

Introduction: Few studies identify which health information (HI) people trust and use, and some studies have focused on health information-seeking behaviors (HISB) of individuals with varying perceived cancer risk (PCR). However, most HISB and PCR studies focus on mainstream populations with typical hearing ability. The purpose of this study was to examine the association between HISB and high PCR (HPCR) among English speakers who experienced hearing loss. Methods: Data from the English version of the 2013 Health Information National Trends Survey (HINTS) 4 Cycle 3 were analyzed. Frequencies were calculated from HINTS 4 Cycle 3 survey questions. Correlation analysis was used to examine relationships between HPCR status and the various trusted HI sources. A significant correlation coefficient (Pearson’s r) was p set at .05. Results: Of the 229 participants self-identifying as experiencing hearing loss, 46 identified as having HPCR. Moreover, over 95% of HCPR participants endorsed speaking English well. In their latest HI search, participants reported they first accessed HI from the internet (28.3%) yet also indicated their most trusted HI source were doctors (97.8%). Pearson’s r indicated no significant relationship between PCR status of participants and degree of trust in HI sources (p &lt; .05). Conclusions: Health professionals should deliver clear and relevant health messages and materials that are understood by individuals who experience hearing loss, including those with HPCR. For individuals who experience hearing loss, health education and communication specialists need to consider alternate communication methods such as writing, speech recognition apps, or captions to support health communication. Keywords: health information seeking-behaviors, hearing loss, perceived cancer risk

Critical Comment on “Knowledge and Risk Perception of Oral Cancer among Rickshaw Drivers in Karad City, Maharashtra, India”

Critical Comment on “Knowledge and Risk Perception of Oral Cancer among Rickshaw Drivers in Karad City, Maharashtra, India”