What Factors Influence Perception of Risk and Screening Behavior

Screening asymptomatic women at average risk of ovarian cancer with available methods transvaginal ultrasound and the CA-125 test has not been shown to be effective and is, therefore, not recommended. Clinical trials currently underway, however, may offer further insight. Such screening procedures, as well as genetic counseling, are recommended for women with a strong family history of cancer indicative of a hereditary genetic mutation, such as BRCA1 or BRCA2. Although the literature demonstrates a positive association between family history and screening behavior, several recent studies have found that women most likely to report high levels of perceived risk and high levels of screening for ovarian cancer were not women at highest risk. In addition, women at high risk for ovarian cancer may not be receiving recommended clinical evaluations. Gaining a comprehensive understanding of the role of risk perception in cancer screening adherence is a priority area for behavioral research in cancer prevention and control. Identifying and elucidating the processes by which women arrive at their perceptions of vulnerability to cancer can shed light on how they make decisions to undergo screening or engage in preventive behaviors. To examine the determinants of perceived risk and its influence on screening behaviors, DCPC is conducting a study of approximately 2000 women at average, elevated, and high risk who will be randomly selected from enrollees in a managed care organization with a racially diverse population. As part of the study, Risk Perception, Worry, and Use of Ovarian Cancer Screening among Women at Average, Elevated, and High Risk of Ovarian Cancer, women will be interviewed by telephone to collect information on family history of cancer, perceived risk, cancer worry, anxiety, personal experiences with cancer in family or friends, and intent to undergo screening or actual screening behavior. A 1-year follow-up telephone interview will be conducted to assess changes in perceived risk or family history of cancer and additional screening activity. The results of this investigation could have important implications for encouraging the appropriate use of screening and for informing educational and communication efforts to maximize screening effectiveness and minimize worry for women at average and elevated risk.