Is There a Cancer Knowledge Paradox? Risk Perception and Knowledge of Breast and Colon Cancer in a Diverse Population

Objective: The accuracy of cancer risk perception has implications for preventive behaviors. Data shows women overestimate their numeric risks. Breast cancer’s media presence is highly visible, perhaps increasing knowledge but inflating risk perceptions. This study explores relationships between breast cancer (BC) and colon cancer (CC) knowledge and numeric risk perceptions among women. We hypothesize that general knowledge of BC will be high relative to CC, but risk perception for BC will be less accurate. Methods: Risk perception and knowledge data was collected from 490 female patients recruited for the Kin Fact study from a Women’s Health Clinic. Women completed baseline surveys and CA Gene software was used to calculate actual lifetime risk for BC and CC. Correlations, t-tests and linear regressions were used for analysis. Results: Women averaged 33 years old, and 59% were African American. Women overestimated their numeric risk for both, but the mean BC overestimation (29%) was significantly larger than CC (19%). Average knowledge scores for BC were also significantly higher than CC. Compared to knowledge about CC, women who had greater knowledge of BC also were more inaccurate in terms of their perceived numeric risk (r=-0.126, p=0.006). This finding remained significant controlling for age, race and genetic literacy. Conclusion: Results endorse an apparently paradoxical effect that compared with CC; women with increased knowledge of BC have less accurate risk perception for BC. Inaccuracies in perceived risk can affect psychosocial well-being and adherence to screening recommendations. Findings reveal need for increasing knowledge without increasing risk misperceptions.