Public perceptions of cancer risk factors: a Western Australian study

Our plain-English summary of Public perceptions of cancer risk factors: a Western Australian study, by A. MacTiernan, L. Fritschi, T. Slevin, et al (Health Promotion Journal of Australia, 2014).

The study

• Authors: A. MacTiernan, L. Fritschi, T. Slevin, G. Jalleh, R. Donovan, J. Heyworth
• Journal: Health Promotion Journal of Australia
• Published: 2014;25(2):90-6
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Issue Addressed: People's perceptions of risk may influence health-related behaviours. The aim of this study was to investigate the perception of cancer risk factors among Western Australian adults in order to inform health promotion policies.

Methods: Cross-sectional surveys of 2094 adults were undertaken in 2007/2008 in which respondents were asked whether they thought factors increased or decreased the risk of cancer. Factors included both established and unestablished risk factors for cancer. The distribution of perceptions was compared according to age and sex.

Results: The study found high levels of endorsement for some unestablished risk factors (74-91%) and comparatively lower levels of endorsement for many established risk factors (33-80%). The established risk factors of smoking and asbestos received high levels of endorsement (94-98%).

Conclusion: It appears that the alignment between scientifically established risk factors and the Western Australian public's perception of cancer risk factors could be improved. SO WHAT? Health promotion strategies are needed to improve the public's awareness of cancer risk factors. The high levels of endorsement attributed to unestablished risk factors highlight the need to dispel myths surrounding cancer and to reinforce the key factors in cancer prevention. Ongoing assessment of the alignment between community perceptions of cancer risk and the scientific evidence for cancer risk is important for guiding prioritisation within public health organisations.

In plain English

In 2007 and 2008, the authors surveyed Western Australian adults by telephone about what they believed raised or lowered cancer risk. Of 6098 randomly selected numbers, many were disconnected or businesses; 1963 residents refused and 2094 completed the interview, which the authors reported as a 52% participation rate. Each person answered one of two question sets: 1072 were asked about diet-related factors and 1022 about lifestyle-related or environmental factors, one of which was asbestos. Among those 1022, 964 (94.3%) said asbestos increased cancer risk. That was 92.1% of people under 45 and 96.1% of those 45 and over, a difference marked statistically significant (p less than 0.05). Only smoking (98%) and passive smoking (95%) were endorsed more often. Some established risk factors had lower recognition, such as alcohol (58%) and red meat (33%). Some factors the authors classed as unestablished, such as food additives (82%) and stress (78%), were widely endorsed. The authors concluded the results highlight gaps in knowledge of cancer risk factors. They noted that prompted questions probably overestimated awareness, and that the low response rate and unrepresentative age mix could bias the results.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional study using two computer-assisted telephone interview surveys
• Who was studied: 2094 adult residents of Western Australia from households randomly selected from White Pages directories, surveyed in 2007 and 2008 (408 in Survey 1, 1686 in Survey 2). Of 6098 numbers selected, 1833 were disconnected, business or fax numbers, 204 were never contacted, 4 were ineligible, 1963 residents refused and 2094 completed the interview. The authors reported a 52% participation rate.
• Exposure: Not an exposure study. Respondents rated whether factors increase, decrease or have no effect on cancer risk. Asbestos was one of 7 established factors in a 16-item lifestyle-related or environmental question set given to 1022 participants. The other 1072 participants were asked about 17 diet-related factors.
• Main results:
  • Among all factors, the highest recognition as cancer risk factors went to smoking (98%), passive smoking (95%) and asbestos (94%), followed by solariums (91%) and chemical fumes (90%).
  • Asbestos was endorsed as increasing cancer risk by 964 of 1022 respondents given the lifestyle-related or environmental survey (94.3%).
  • Asbestos endorsement by age: 397 (92.1%) of respondents under 45 years versus 562 (96.1%) of those 45 years and over. The table marks this difference p less than 0.05.
  • Asbestos endorsement by sex: 458 men (92.9%) and 506 women (95.7%). The table gives no statistical significance marker for this difference.
  • Established risk factors with low recognition were alcohol (58%), beer (40%), salt (34%) and red meat (33%).
  • Unestablished factors with high endorsement as risk factors included food additives (82%) and stress (78%).
  • Participants in the lifestyle-related or environmental survey endorsed on average 6 of 7 established factors and 2.81 of 7 unestablished factors. Women endorsed more of both than men.
  • 43% of the sample endorsed red wine as protective against cancer.
• The authors' conclusion: The authors concluded that the results highlight gaps in knowledge of cancer risk factors among this sample of Western Australian adults. They also concluded that high endorsement of unestablished factors shows a need to dispel myths and reinforce key prevention factors.
• Limitations the authors state:
  • Prompted questions likely produced an overestimate of public awareness compared with open-ended recall.
  • Respondents were not asked about individual cancer types, and might have answered more accurately if they had been.
  • The low response fraction may have caused bias, and the sample did not reflect the age mix of the general population, limiting generalisability.
  • Education and socioeconomic status were not collected, although they may have influenced awareness.
  • The labels 'established' and 'unestablished' are subject to ongoing scientific debate.

Related studies

• Perceptions of health hazards in the narratives of Italian migrant workers at an Australian asbestos mine (1943-1966) — F. Cappelletto, E. Merler (2003)
• Asbestos in the air of public buildings: a public health risk? — J. Whysner, V.T. Covello, et al. (1994)
• Student nurses' risk perceptions of home environmental hazards — B.J. Polivka, C. Wills (2014)
• The precautionary principle and/or risk assessment in World Trade Organization decisions: a possible role for risk perception — B. Goldstein, R.S. Carruth (2004)
• Anxious and depressive symptoms in the French Asbestos-Related Diseases Cohort: risk factors and self-perception of risk — I. Mounchetrou Njoya, C. Paris, et al. (2017)
• Ultra low dose CT screen-detected non-malignant incidental findings in the Western Australian Asbestos Review Programme — C.P. Murray, P.M. Wong, et al. (2016)

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