A Study of Women’s Perceived and Actual Risk of Getting Cancer

People’s beliefs about how likely they are to get cancer, called perceived cancer risk, can affect their decision to do things that can lower their cancer risk, like getting cancer screening tests, having an operation to help prevent cancer, or making changes to improve their health. Many studies have shown that people’s actual cancer risk (based on a risk assessment by a doctor) may be different from their own beliefs about how likely they are to get cancer.

Researchers wanted to understand the factors that influence a woman’s beliefs about her risk of getting cancer and how they may affect the decisions she makes about her health care. Researchers also wanted to know which women were being referred for genetic counseling and getting genetic testing, and whether women were getting cancer screening tests.

Around 2,500 women 30 years of age and older in the Henry Ford Health Systems in Southeastern Michigan participated in the study. These women were asked about—

• Their personal history of cancer.
• Their family history of cancer.
• What cancer screening tests they had received.
• If they had a friend or relative who had cancer, and if so, how close they were to this friend or relative.
• If they worried about getting cancer.
• Their own beliefs about getting cancer.
• If they had ever received genetic counseling and testing.

Key Findings

• Although all women had access to cancer genetic counseling and testing through their health system, many women who had a high risk of cancer because a family member had breast or ovarian cancer did not use these services.
• Having a family member or a friend with cancer influences how a woman thinks about her own risk of ovarian cancer. These findings help to explain why there is a difference between a woman’s actual risk of cancer and her beliefs about how likely she is to get cancer.
• Breast cancer survivors face higher risks for ovarian cancer, and may benefit from genetic counseling and testing. But most breast cancer survivors didn’t know about this risk, so they didn’t get genetic counseling.
• Researchers developed a new scale to measure how close a person is to the cancer experience. The scale is based on questions about family and friends who have had cancer and the closeness of those relationships. This scale may help health care professionals counsel people who have a high risk of cancer.

Citations

This article summary highlights the findings in the following papers.

Alford SH, Leadbetter S, Rodriguez JL, Hawkins, NA, Scholl LE, Peipins LA. Cancer screening among a population-based sample of insured women. Preventive Medicine Reports 2015;2:15–20.

Peipins LA, McCarty F, Hawkins NA, Rodriguez JL, Scholl LE, Leadbetter S. Cognitive and affective influences on perceived risk of ovarian cancer. Psycho-Oncology 2015;24(3):279–286.

Bellcross CA, Peipins LA, McCarty F, Rodriguez JL, Hawkins NA, Alford SH, Leadbetter, S. Characteristics associated with genetic counseling referral and BRCA1/2 testing among women in a large integrated health system. Genetics in Medicine 2014;17:43–50.

Leadbetter S, Hawkins NA, Scholl LE, McCarty FA, Rodriguez JL, Freedner-Maguire N, Alford SH, Bellcross CA, Peipins LA. Recruiting women for a study on perceived risk of cancer: influence of survey topic salience and early versus late response. Preventing Chronic Disease 2013;10:120293.

Bellcross CA, Leadbetter S, Peipins LA, Alford, SH. Prevalence and healthcare actions of women in a large health system with a family history meeting the 2005 USPSTF recommendation for BRCA genetic counseling referral. Cancer Epidemiology, Biomarkers and Prevention 2013;22(4):728–735.

Hawkins NA, McCarty F, Peipins LA, Rodriguez JL. Measuring the degree of closeness to the cancer experience: Development and initial validation of the CONNection to the Experience of Cancer Scale (CONNECS). Patient Education and Counseling 2012;89(2):292–299.