title: Factors influencing cancer risk perception in high risk populations: a systematic review.
abstract: BACKGROUND
  Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history.
  
  
  METHODS
  We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk.
  
  
  RESULTS
  Of 1028 titles identified, 53 articles met our criteria. Most (92%) used an observational design and focused on women (70%) with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups) and few employed theory-driven analytic strategies to decipher interrelationships of factors.
  
  
  CONCLUSIONS
  Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although evolving, is still relatively undeveloped in several key topic areas including cancers other than breast and in specific populations. Future rigorous risk perception research using experimental designs and focused on cancers other than breast would advance the field.
authors: Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. tilburt.jon@mayo.edu.
authors: Jon C
authors: JC
authors: Tilburt
authors: Katherine M
authors: KM
authors: James
authors: Pamela S
authors: PS
authors: Sinicrope
authors: David T
authors: DT
authors: Eton
authors: Brian A
authors: BA
authors: Costello
authors: Jantey
authors: J
authors: Carey
authors: Melanie A
authors: MA
authors: Lane
authors: Shawna L
authors: SL
authors: Ehlers
authors: Patricia J
authors: PJ
authors: Erwin
authors: Katherine E
authors: KE
authors: Nowakowski
authors: Mohammad H
authors: MH
authors: Murad
references: Cancer Epidemiol Biomarkers Prev. 1999 Apr;8(4 Pt 2):345-51
references: 10207639
references: Psychooncology. 2008 Aug;17(8):756-66
references: 18613300
references: CMAJ. 2001 Apr 3;164(7):1005-9
references: 11314429
references: Am J Med Genet C Semin Med Genet. 2006 Nov 15;142C(4):251-9
references: 17024668
references: Br J Cancer. 1999 Feb;79(5-6):868-74
references: 10070883
references: J Genet Couns. 2006 Dec;15(6):449-60
references: 17013546
references: Cancer. 2004 Apr 1;100(7):1537-44
references: 15042690
references: J Clin Oncol. 2006 Nov 10;24(32):5132-7
references: 17093275
references: J Psychosom Res. 2003 Nov;55(5):437-43
references: 14581098
references: J Natl Cancer Inst Monogr. 1999;(25):101-19
references: 10854465
references: J Womens Health (Larchmt). 2006 Sep;15(7):843-56
references: 16999640
references: Genet Test. 2007 Summer;11(2):183-6
references: 17627391
references: Patient Educ Couns. 2007 Jan;65(1):58-68
references: 16872788
references: Eur J Cancer. 2000 Jan;36(2):235-41
references: 10741283
references: Prev Med. 2004 Aug;39(2):315-22
references: 15226040
references: Health Psychol. 1990;9(6):792-806
references: 2286186
references: Ann Intern Med. 2009 Aug 18;151(4):264-9, W64
references: 19622511
references: Patient Educ Couns. 2004 Nov;55(2):265-74
references: 15530764
references: Health Psychol. 1995 Mar;14(2):132-40
references: 7789348
references: Clin Genet. 2005 Jun;67(6):481-91
references: 15857415
references: Ann Behav Med. 1997 Fall;19(4):362-9
references: 9706363
references: Psychosomatics. 2001 Jul-Aug;42(4):330-6
references: 11496022
references: Prev Med. 2003 Nov;37(5):424-31
references: 14572427
references: J Natl Cancer Inst Monogr. 1994;(16):171-6
references: 7999461
references: J Health Commun. 2005;10 Suppl 1:119-36
references: 16377604
references: Cancer Epidemiol Biomarkers Prev. 2000 Apr;9(4):381-5
references: 10794482
references: Behav Med. 2005 Spring;31(1):33-40
references: 16078524
references: Cancer Nurs. 2006 May-Jun;29(3):227-35
references: 16783123
references: J Womens Health (Larchmt). 2005 Nov;14(9):845-51
references: 16313212
references: Medscape Womens Health. 2002 Mar-Apr;7(2):2
references: 12142858
references: Psychooncology. 2008 Aug;17(8):783-9
references: 18688785
references: Ann Behav Med. 2000 Winter;22(1):53-9
references: 10892528
references: Psychooncology. 2003 Dec;12(8):821-7
references: 14681955
references: Br J Cancer. 2007 Aug 20;97(4):486-93
references: 17700548
references: Br J Cancer. 2004 Jan 26;90(2):321-7
references: 14735171
references: Cancer Epidemiol Biomarkers Prev. 1992 Jan-Feb;1(2):143-7
references: 1306097
references: Cancer Epidemiol Biomarkers Prev. 2001 Jan;10(1):35-43
references: 11205487
references: Health Psychol. 1998 Jul;17(4):371-5
references: 9697947
references: Health Psychol. 2002 Sep;21(5):485-94
references: 12211516
references: CA Cancer J Clin. 2007 May-Jun;57(3):147-67
references: 17507441
references: Ann Oncol. 2004;15 Suppl 1:I48-I54
references: 15280188
references: Health Psychol. 1995 May;14(3):232-5
references: 7641664
references: Psychol Health. 2006;21(2):211-30
references: 21985118
references: Prev Med. 1995 Jul;24(4):412-9
references: 7479633
references: Clin Genet. 2000 Dec;58(6):460-8
references: 11149615
references: Ann Behav Med. 1997 Fall;19(4):370-7
references: 9706364
references: Br J Cancer. 2003 Jun 2;88(11):1675-81
references: 12771979
references: J Genet Couns. 2007 Apr;16(2):211-22
references: 17279329
references: J Health Commun. 2006 Jun;11(4):391-407
references: 16720537
references: Patient Educ Couns. 2008 Nov;73(2):209-14
references: 18602242
references: Cancer Epidemiol Biomarkers Prev. 1999 Jul;8(7):635-9
references: 10428202
references: BMJ. 2001 Jan 13;322(7278):76
references: 11154619
references: J Clin Oncol. 2005 Oct 1;23(28):6890-8
references: 16129845
references: J Genet Couns. 2005 Apr;14(2):119-32
references: 15959643
references: Gynecol Oncol. 2003 Jun;89(3):440-6
references: 12798709
references: Health Psychol. 2006 Mar;25(2):171-80
references: 16569108
references: Prev Med. 2004 Apr;38(4):388-402
references: 15020172
references: Fam Cancer. 2001;1(3-4):149-56
references: 14574171
references: Qual Health Care. 2001 Sep;10 Suppl 1:i9-13
references: 11533431