Laypersons' responses to the communication of uncertainty regarding cancer risk estimates.
OBJECTIVE
To explore laypersons' responses to the communication of uncertainty associated with individualized cancer risk estimates and to identify reasons for individual differences in these responses.


METHODS
A qualitative study was conducted using focus groups. Participants were informed about a new colorectal cancer risk prediction model, and presented with hypothetical individualized risk estimates using presentation formats varying in expressed uncertainty (range v. point estimate). Semistructured interviews explored participants' responses to this information.


METHODS
Eight focus groups were conducted with 48 adults aged 50 to 74 residing in 2 major US metropolitan areas, Chicago, IL and Washington, DC. Purposive sampling was used to recruit participants with a high school or greater education, some familiarity with information technology, and no personal or immediate family history of cancer.


RESULTS
Participants identified several sources of uncertainty regarding cancer risk estimates, including missing data, limitations in accuracy and source credibility, and conflicting information. In comparing presentation formats, most participants reported greater worry and perceived risk with the range than with the point estimate, consistent with the phenomenon of "ambiguity aversion.'' However, others reported the opposite effect or else indifference between formats. Reasons suggested by participants' responses included individual differences in optimism and motivations to reduce feelings of vulnerability and personal lack of control. Perceptions of source credibility and risk mutability emerged as potential mediating factors.


CONCLUSIONS
Laypersons' responses to the communication of uncertainty regarding cancer risk estimates differ, and include both heightened and diminished risk perceptions. These differences may be attributable to personality, cognitive, and motivational factors.
Han
Paul K J
PK
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA. hanp@mail.nih.gov
Klein
William M P
WM
Lehman
Thomas C
TC
Massett
Holly
H
Lee
Simon C
SC
Freedman
Andrew N
AN
D000368:Aged; D002641:Chicago / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000523:psychology*; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D018570:Risk Assessment; D035501:Uncertainty