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Health Education Research Advance Access originally published online on June 26, 2006
Health Education Research 2006 21(5):740-749; doi:10.1093/her/cyl049
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© The Author 2006. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Factors associated with colorectal cancer risk perception: the role of polyps and family history

Jennifer Rider Stark1,*, Elizabeth R. Bertone-Johnson2, Mary E. Costanza3 and Anne M. Stoddard4

1 Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
2 Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
3 Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
4 Center for Statistical Analysis and Research, New England Research Institutes, Watertown, MA 02472, USA

*Correspondence to: J. R. Stark. E-mail: stark{at}hsph.harvard.edu

It is unclear how objective risk factors influence the factors associated with colorectal cancer (CRC) risk perception. The goals of this study were to investigate factors associated with perceived risk of CRC and to explore how these relationships were modified by personal history of polyps or family history of CRC. The study involved a mailed questionnaire completed by 1646 men and women aged 50–75 years, which assessed perceived risk, demographic and health history variables and CRC worry. Participants were patients of primary care providers in a community medical group in central Massachusetts. The study sample seemed to have a generally accurate perception of CRC risk, which was appropriately increased in the presence of known risk factors. In multivariable analyses that controlled for all measured covariates, financial situation modified the association between perceived risk and a personal history of polyps, while age and insurance status modified the association between perceived risk and family history of CRC. CRC worry, self-reported health, personal history of other cancer and compliance with screening guidelines remained significant predictors of perceived risk. Potential interactions between objective risk factors and socioeconomic characteristics should be further explored in longitudinal studies.


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