The 130th Annual Meeting of APHA

Abstract #51746

Sabrina T. Wong, RN, PhD¹, Eliseo J. Perez-Stable, MD², Deirdra Forte, MPH¹, Celia P Kaplan, DrPH¹, George Sawaya, MD³, Judith Walsh, MD, MPH², and A. Eugene Washington, MD, MSc⁴. (1) Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, Box 0856, 3333 California Street, Suite 335, San Francisco, CA 94143, 415-514-3355, sabrina@itsa.ucsf.edu, (2) Department of General Internal Medicine, University of California San Francisco, 3333 California Street, Suite 335, San Francisco, CA 94143, (3) Department of OB/Gyn, University of California, San Francisco, 3333 California Street, Suite 335, Box 0856, San Francisco, CA 94143, (4) Medical Effectiveness Research Center, UCSF, UCSF, Suite 335, 3333 California Street, San Francisco, CA 94143-0856

There is wide variation amongst breast, colon, and cervical screening rates in women from different racial/ethnic backgrounds. Examining women’s perception of risk of an adverse outcome can contribute to determining adherence to specific screening recommendations. However, little is known about how women perceive their risk of getting breast, colon, or cervical cancer or how clinicians convey this risk. Three of our specific aims are to: a) evaluate the perception of risk of breast, colon, and cervical cancer and compare to actual risk in a sample of 1,200 women from four ethnic groups; b) identify and evaluate methods to convey risk in a sample of 1,200 women eligible for chemoprevention breast cancer, screening for colorectal cancer, and stopping screening for cervical cancer; and 3) evaluate the role of women’s perception of risk and reported interpersonal processes of care with their clinician on the frequency of active participation in discussions about the risks and benefits for use of chemoprevention, obtaining screening for colorectal caner, and stopping screening for cervical cancer after age 65 years. In conducting qualitative work, our goal was to gather information on perception of risk and methods of conveying risk in order to develop an instrument. With this measure, we will quantitatively examine whether differential screening rates are related to differences in risk perception and methods by which risk is conveyed to women of different racial/ethnic backgrounds. We have conducted 24 in-depth interviews with African American, Latino, White, and Asian (Chinese)women recruited through physician practices or public health departments. Women were also asked to assess the added benefit of several numerical formats (e.g. absolute risk, relative risk) in presenting risk. Preliminary analysis reveals that women perceive their risk of getting breast, colon, or cervical cancer in terms of risk factors such as heredity, the environment, and lifestyle choices (e.g. smoking, poor diet). It appears that women do not perceive risk in terms of numbers. Women do not recall their clinician explaining why screening tests were an important method in detecting cancer but many relied on their clinician’s recommendation when deciding to get a screening test. However, when asked if they would like to discontinue yearly Pap smears based on the clinician’s recommendation, many women reported they would then request this yearly screening test. While clinicians typically report risk information as percentages or relative risks, evidence from past studies and our interviews suggests that people may code information qualitatively.

Learning Objectives: Participants will learn

• one method to study patient-physician communication
• women's perception of their risk of getting breast, colon, or cervical cancer

Keywords: Risk Communication, Risk Assessment

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.