African-Americans have highest cancer rates of all racial ethnicities, yet feel less at risk, study finds

However, a new study by University at Buffalo researchers shows that persons of different ethnic groups have different ideas and opinions about whether they are at risk for developing cancer -- perceptions that can influence whether they undergo screening.

The study results reveal that blacks feel less at risk of getting cancer than do whites -- the comparison group in the study -- although they have the highest cancer incidence and mortality of all racial/ethnic groups.

Hispanics and Asians also believed they were at a lower risk than whites, results show, and the differences remained in all groups even when variables such as age and education are considered.

The study appears in the March issue of Cancer Epidemiology, Biomarkers and Prevention.

"Our level of perceived cancer risk can affect our health and longevity," says Heather Orom, PhD, assistant professor in the UB Department of Health Behavior, School of Public Health and Health Professions, and first author on the study.

"Believing that we could develop cancer in our lifetime can motivate us to undergo tests, such as colonoscopy or mammogram to detect cancer early. This knowledge also may motivate us to engage in behavior such as exercising and eating more fruits and vegetables that can reduce our chances of getting the disease.

"In order to reach all racial and ethnic groups successfully about the importance of cancer screening," she continues, "we need to know their perceptions of being at risk for cancer, why and how those perceptions differ and which are most important for influencing behavior across groups. This information is crucial to improving public health messaging."

The study is based on the responses of 5,581 adults who completed the 2007 Health Information Trends Survey (HINTS) conducted by the National Cancer Institute to study the perception of a person's overall cancer risk.

Respondents were asked how likely they thought it was that they would develop cancer in the future, (to determine their perceived risk) and answered questions on their family's history of cancer, their history of cigarette smoking, how they rated their current health and their beliefs about the disease.

Results showed that blacks were less likely to report cancer in the family, which was associated with thinking they had a lower risk of developing the disease than did whites. Similar patterns emerged for Hispanics and Asians, results showed.

"Knowing that one has a family history of cancer typically makes people feel that they have a greater chance of getting cancer in their lifetime," says Orom. "A number of studies have shown that non-whites, including blacks, Hispanics and Asians, are less likely to be aware of having a family history of cancer than whites."

Being unaware of cancer in the family is only one of many factors contributing to racial/ethnic differences in perceived cancer risk, notes Orom. "Our data also are consistent with previous research showing that public health messages about cancer are not as widely disseminated in predominantly minority communities, which may contribute to lower perceptions of risk for getting cancer."

Perceived risk also was lower among Hispanics and Asians because fewer members had a history of smoking, results showed. "Some cancers are strongly associated with smoking and others are not," Orom says. "It's possible that if nonsmokers think they are at low risk of developing all cancers, it could keep them from getting cancer screening and embracing habits associated with lowering risk, such as eating more fruits and vegetables and being more physically active."

One factor the study did not address is whether differences in perceived cancer risk contribute to documented lower rates of cancer screening among non-whites compared to whites, Orom says. "We plan to address this question in our future research."

Additional contributors to the study were Marc T. Kiviniemi, PhD, UB assistant professor of health behavior; Willie Underwood III, MD, MPH, assistant professor of urologic oncology and health disparities at Roswell Park Cancer Institute (RPCI) in Buffalo; Levi Ross, PhD, MPH, assistant professor of oncology in the Office of Cancer Health Disparities Research at RCPI, and Vickie L. Shavers, PhD, of the National Cancer Institute.