Examining intuitive risk perceptions for cancer in diverse populations

Abstract

In this article, we examine intuitive dimensions of personal cancer risk likelihood, which theory and empirical evidence indicate may be important elements in the risk perception process. We draw on data from a study of risk perceptions in three social groups: university students, men living in the community, and primary care patients living in an urban area. The study took place from 2007 to 2011, in Garden City and New York City, NY and Boston, MA. This study used items developed from categories identified in prior qualitative research specifying emotions and attitudes activated in cancer risk determination to examine perception of cancer risks. Across three samples – university students (N = 568); community men (N = 182); and diverse, urban primary care patients (N = 127) – we conducted exploratory factor and construct analyses. We found that the most reliable two factors within the five-factor solution were cognitive causation, tapping beliefs that risk thoughts may encourage cancer development, and negative affect in risk, assessing negative feelings generated during the risk perception process. For these factors, there were high levels of item endorsement, especially in minority groups, and only modest associations with established cancer risk perception and worry assessments, indicating novel content. These items may prove useful in measuring and comparing intuitive cancer risk perceptions across diverse population subgroups.

Keywords:

• intuition
• risk
• risk perceptions
• diverse populations
• measure development
• cancer risk perceptions
• decision-making

Acknowledgements

We acknowledge the contributions of our item development expert panel (Gustavo Cruz, Isaac Lipkus, Jamie Ostroff, Elyse Shuk, and Neil Weinstein), Debra Brennessel, Linda Bulone, Margaret Michel, and Soye Zaid-Muhammad for facilitating our Urban Primary Care Study at Queens Hospital Center, Andrea Gurmankin-Levy for data collection of the community men study and Kevin McCaul for his help in data interpretation. We also appreciate the valued assistance of Sherice Davis, Susan Gall, Marcel Ramos, and Christopher Webster in manuscript preparation.

Funding

This project was supported by NIH grant support R03 CA93182, K07 CA098106, and R21 CA133376 to Jennifer Hay.