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Women's perception of risk affects screening for colon cancer, but not cervical or breast cancer

How older women perceive their risk of developing colon cancer significantly affects whether they get screened for it. However, a new study finds that risk perception does not seem to affect screening for cervical or breast cancer.

Researchers interviewed 1,160 white, black, Hispanic, and Asian women (50 to 80 years of age) from primary care practices in San Francisco about their perceived risk for breast, cervical, and colon cancer. They compared their perceived risk with self-reported screening behavior by ethnicity.

The perceived lifetime risk of cancer varied by ethnicity, with Asian women generally perceiving the lowest risk and Hispanic women the highest risk for all three types of cancer. For example, compared with white women, Hispanic women had three times higher perceived risk for cervical cancer and colon cancer, and Asian women had 40 percent lower perceived risk for both cancers. There were no significant differences in risk perception between black and white women for cervical, breast, and colon cancer, even though black women suffer higher incidence and deaths from these cancers. Close to 90 percent of women reported having undergone mammography and about 70 percent reported having had a Pap test in the previous 2 years. About 70 percent of the women studied were current on colon cancer screening.

After demographic factors and cancer history were controlled for, there was no significant relationship between perception of cervical or breast cancer and having had a Pap test or mammogram in the prior 2 years. However, reporting a moderate to very high risk perception for colon cancer was associated with nearly three times higher odds of having undergone colonoscopy in the last 10 years.

These findings suggest that communication of cancer risk information may serve as an important tool to promote screening and early cancer detection. The study was supported in part by the Agency for Healthcare Research and Quality (HS10856).

See "Association between cancer risk perception and screening behavior among diverse women," by Sue E. Kim, Ph.D., M.P.H., Eliseo J. Perez-Stable, M.D., Sabrina Wong, R.N., Ph.D., and others, in the April 14, 2008, Archives of Internal Medicine 168(7), pp. 728-734.

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