Cancer risk perception and physician communication behaviors on cervical cancer and colorectal cancer screening

Department of Family Medicine, University of Michigan School of Medicine, United States
Department of Obstetrics & Gynecology, University of Michigan School of Medicine, United States
Department of Women’s Studies, University of Michigan, College of Literature, Science and the Arts, United States
Arab Community Center for Economic and Social Services (ACCESS), United States
Department of Health Behavior & Health Education, University of Michigan School of Public, United States
Outreach and Health Disparities Research, University of Michigan Rogel Cancer Center, United States
Center for Health Communications Research, University of Michigan, School of Public Health, United States

Aug 24, 2021

7 tables and 5 additional files

Tables

Table 1

Cancer risk perception and knowledge
Cancer is most often caused by a person’s behavior or lifestyle
It seems like everything causes cancer
I'd rather not know my chance of getting cancer
There’s not much you can do to lower your chances of getting cancer
There are so many recommendations about cancer prevention, it’s hard to know which ones to follow
When I think about cancer, I automatically think about death
How likely are you to get cancer in your lifetime compared to others your age?
Physician communication behavior – In the past 12 months, how often did your PCP …
Give you the chance to ask all health-related questions
Give you the attention you needed to your feelings/emotions
Involve you in the decisions about your health care as much as you wanted
Make sure you understood the things you needed to do to take care of your health
Explain things in a way you could understand
Spend enough time with you
Help you deal with feelings of uncertainty about your health or health care

Table 2

Age, years (mean, SD)	57.7	4.5
Race/ethnicity	N	%
White	271	68.8
African American/Black	75	19.0
Other*	11	2.8
MENA (Middle Eastern North African)	37	9.4
Religion
Christian^†	241	63.6
Jewish	14	3.7
Muslim	26	6.9
No religion/no belief in god	98	25.9
Education
High school or less	85	21.6
Some college	123	31.2
College graduate	138	35.0
Post college education	48	12.2
Marital status^‡
Married/partnered	236	59.9
Single	156	39.6
Income
<$10,000	28	7.1
$10–49,999	148	37.6
$50–99,999	140	35.5
≥$100,000	70	17.8
Any chronic condition^§	291	73.9

*Other includes Asian or other Pacific Islander, Hispanic, American Indian, and multi-race. This group was further excluded from our analyses.

^†Christian includes Chaldean, Coptic, Assyrian, Catholic, Jehovah Witness.
^‡Married/partnered includes married and living as married; single includes divorced, widowed, separated, and never been married.

^§Chronic conditions include diabetes, hypertension, heart disease (heart attack, angina, congestive heart failure), lung disease (asthma, emphysema, chronic bronchitis), arthritis, depression, or cancer.

Table 3

	Both cervical cancer and CRC screening		Neither screening		Cervical cancer screening alone		CRC screening alone
N=394	N=213		N=52		N=82		N=47
Cancer risk perceptions and knowledge	N	%	N	%	N	%	N	%
Cancer is caused by behavior or lifestyle
Strongly/somewhat disagree	128	60.1%	29	58.0%	45	58.4%	30	63.8%
Somewhat/strongly agree	85	39.9%	21	42.0%	32	41.6%	17	36.2%
Everything causes cancer
Strongly/somewhat disagree	74	34.7%	15	29.4%	28	35.9%	16	34.0%
Somewhat/strongly agree	139	65.3%	36	70.6%	50	64.1%	31	66.0%
I’d rather not know my chance of getting cancer
Strongly/somewhat disagree	160	75.8%	32	61.5%	53	68.8%	38	80.9%
Somewhat/strongly agree	51	24.2%	18	38.5%	24	31.2%	9	19.2%
There’s not much you can do to lower your chances of getting cancer (1)
Strongly/somewhat disagree	180	84.9%	35	67.3%	59	77.6%	36	76.6%
Somewhat/strongly agree	32	15.1%	17	32.7%	17	22.4%	11	23.4%
There are so many recommendations about cancer prevention, it’s hard to know which ones to follow
Strongly/somewhat disagree	74	34.9%	13	25.0%	19	24.7%	13	27.7%
Somewhat/strongly agree	138	65.1%	39	75.0%	58	75.3%	34	72.3%
When I think about cancer, I automatically think about death (2)
Strongly/somewhat disagree	110	51.9%	28	48.1%	26	33.8%	19	40.4%
Somewhat/strongly agree	102	48.1%	27	51.9%	51	66.2%	28	59.6%
How likely are you to get cancer in your lifetime compared to others your age?
Much less, less likely or about the same	177	83.5%	47	90.4%	65	83.3%	35	74.5%
More or much more likely	35	16.5%	5	9.6%	13	16.7%	12	25.5%

Table 4

	Both cervical cancer and CRC screening		Neither screening		Cervical cancer screening alone		CRC screening alone
N=394	N=213		N=52		N=82		N=47
Communication behaviors
Chance to ask all health-related questions (1)
Always/usually	195	92.9%	33	94.3%	62	82.7%	37	86.1%
Sometimes/never	15	7.1%	2	5.7%	13	17.3%	6	14.0%
Give you the attention you needed to your feelings/emotions (2)
Always/usually	188	90.8%	31	86.1%	54	73.0%	30	73.2%
Sometimes/never	19	9.2%	5	13.9%	20	27.0%	11	26.8%
Involved you in the decisions about your health care as much as you wanted (3)
Always/usually	191	92.7%	29	76.3%	60	81.1%	35	83.3%
Sometimes/never	15	7.3%	9	23.7%	14	18.9%	7	16.7%
Make sure you understood the things you needed to do to take care of your health (4)
Always/usually	193	93.7%	36	94.7%	64	83.1%	37	86.1%
Sometimes/never	13	6.3%	2	5.3%	13	16.9%	6	14.0%
Explain things in a way you could understand
Always/usually	192	93.7%	33	86.8%	65	84.4%	38	88.4%
Sometimes/never	13	6.3%	5	13.2%	12	15.6%	5	11.6%
Spend enough time with you (5)
Always/usually	188	91.3%	31	86.1%	58	75.3%	34	79.1%
Sometimes/never	18	8.7%	5	13.9%	19	24.7%	9	20.9%
Help you deal with feelings of uncertainty about your health or health care (6)
Always/usually	161	88.5%	28	87.5%	54	74.0%	30	75.0%
Sometimes/never	21	11.5%	4	12.5%	19	26.0%	10	25.0%

Table 5

	Both screens compared to neither			Both compared to a cervix only
Cancer risk perception and knowledge	aOR	L95	U95	aOR	L95	U95
There’s not much you can do to lower your chances of getting cancer
Strongly/somewhat disagree	1.65	1.16	2.35	1.18	0.85	1.66
Somewhat/strongly agree	1.0			1.0
When I think about cancer, I automatically think about death
Strongly/somewhat disagree	1.0	0.73	1.36	1.41	1.07	1.86
Somewhat/strongly agree	1.0			1.0

Bold/red is significant.

No other screening population comparison was significant.
No other beliefs about cancer were significant.

Adjusted for all cancer risk perception and knowledge questions.

Table 6

	Both screenings compared to neither			Both screenings compared to cervix only
Communication behavior	aOR	L95	U95	aOR	L95	U95
Did your PCP involve you in the decisions about your health care as much as you wanted
Always/usually	1.99	1.26	3.14	1.72	1.16	2.55
Sometimes/never	1.0			1.0

PCP means primary care physician.

Bold/red is significant.
No other communication behavior was significant.

No other screening population comparison was significant.
Adjusted for all communication behavior questions.

Table 7

	Both screens compared to neither			Both compared to cervix alone			Cervix only compared to CRC alone
	aOR	L95	U95	aOR	L95	U95	aOR	L95	U95
Age	1.05	0.97	1.14	1.13	1.06	1.21	0.84	0.77	0.93
Race/ethnicity
White	1.0			1.0			1.0
Black	1.74	0.87	3.46	1.76	1.03	3.00	0.49	0.20	1.24
MENA	0.33	0.15	0.70	0.30	0.16	0.56	4.59	1.13	18.67
Did your PCP involve you in the decisions about your health care as much as you wanted?
Always/usually	1.96	1.22	3.15	1.58	1.04	2.42	1.01	0.59	1.73
Sometimes/never	1.0			1.0			1.0