Abstract

Perceived cancer risk plays a prominent role in many theories of health behavior and is commonly used to study several important cancer control outcomes. However, there is much yet to learn about this important variable, including how it should be measured and how it influences behavior and psychological adjustment. One intriguing aspect of perceived cancer risk not addressed in the literature involves potential sex differences in cancer risk perceptions. The purpose of this study was to determine if women and men, who have similar colon cancer incidence rates, maintain different colon cancer risk perceptions. Five methods of assessing perceived colon cancer risk were administered to examine potential differences. Respondents included 97 women participating in ovarian cancer screening and their male partners. Sample mean age and education level were 60.5 (±10.2) and 14.1 (±3.0) years, respectively. Results showed that women reported significantly higher colon cancer risk perceptions on two of the five indexes and generally higher estimates on all five measures. Among women, higher perceived risk estimates were independently associated with higher colon cancer distress, family history of colon cancer, and lower levels of social functioning, while higher perceived risk estimates among men were independently associated with lower physical functioning and not having private health insurance. These data suggest sex differences in colon cancer risk perceptions. Differences appeared in absolute levels as well as in correlates of
perceived risk estimates. Future research with larger and nonrelated samples should continue to examine sex differences in cancer risk perception and their impact on cancer screening behavior and psychological adjustment.

Introduction

Background
• Perceived risk is prominently featured in many models of health behavior.
– Health Belief Model
– Precaution Adoption Process Model
• Perceived risk is also used as an outcome variable in cancer risk communication trials and other clinical settings.
• Perceived risk has also been studied as a criterion variable in order to understand how risk perceptions develop.

Purpose
• The overall goal of the study was to expand our knowledge of the perceived risk construct.
– The primary aim of the study was to examine whether women and men differ in their beliefs regarding susceptibility to cancer.
– The secondary aim was to identify factors that could potentially explain sex/gender differences if these differences exist.

Method

Procedure
• Sample
– Screening Group (SG): 97 women prior to receiving transvaginal ultrasound screening
– Male Partner Group (MG): 97 male spouses of screening group members
• Questionnaire Survey
– 25-45 minute survey administration

Measures
• Perceived Colon Cancer Risk
– Champion’s Susceptibility Scale
– Percentage Method (0 to 100%)
– Weinstein’s Stages of Perceived Risk
– Likelihood Item
– Relative Risk Question
• Other Measures
– Colon Cancer-specific Distress (IES-R)
– Health Status/Quality of Life (SF-36)

Sample Characteristics
• Mean Age: 61 years (±10), range 30 – 84
• Mean Education: 14 years (±3), range 6 – 20
• Median Income: $40,000 – $50,000 annually
• 100% Caucasian
• 99% Married
• 44% Retired
• 78% Private Insurance
* No group differences were identified based on t and χ2 tests

Colon Cancer Risk Profiles*
• Family history of colon cancer 25%
• Personal Hx of a polyp 20%
• Personal Hx of inflammatory bowel disease 10%
• Regular exercise 50%
• Consuming too few fruits and vegetables 33%
• Consuming too much dietary fat 38%
* No group differences were identified based on χ2 tests.

Results

Differences in CC Risk Perception (Mean and Standard Deviation)

Champion Measure
Screening Group: 2.53 (0.7)
Partner Group: 2.47 (0.7)
p = .53

Percentage Method
Screening Group: 23.2 (23.6)
Partner Group: 16.7 (16.5)
p = .03*

Weinstein Stage
Screening Group: 3.26 (1.7)
Partner Group: 3.16 (1.7)
p = .69

Likelihood Item
Screening Group: 3.63 (1.7)
Partner Group: 3.69 (1.6)
p = .81

Relative Risk Item
Screening Group: 2.88 (0.9)
Partner Group: 2.59 (0.8)
p = .02*

Correlates of CC Risk Perception*
Screening Group
• Percentage Method
– Colon Cancer-specific Distress (r = .27)
– Social Functioning (r = -.37)
• Relative Risk Method
– Family History of Colon Cancer (r = .29)

Male Partner Group
• Percentage Method
– Vitality (r = -.25)
– Private Insurance (r = -.23)
• Relative Risk Method
– Physical Functioning (r = -.24)

* Independent predictors of CC Risk Perception based on Multiple Regression Analyses.

Discussion

Summary

• Differences in CC Risk Perception
– Generally, women reported higher estimates of colon cancer risk, and the estimates were significantly higher on two of the five measures of perceived colon cancer risk.
– However, the group differences were not overly dramatic
• Correlates of CC Risk Perception
– Among women higher colon cancer risk perceptions were related to social, emotional, and objective risk factors, while in men higher colon cancer risk perceptions were related to physical functioning and socioeconomic factors.

Conclusions
• Although risk perception plays a prominent role in conceptualizing health behavior, we have much to learn with regard to measuring and utilizing this important variable.
• These data suggest that gender differences in cancer risk perception may be an important factor to consider when tailoring information for health promotion programs.
• Additional research in larger and non-related samples is necessary to validate this early finding.