Strategies for Reducing the Risk of Developing Cancer

Participants were asked about the kinds of activities in which they engaged to reduce the risk of developing breast cancer. Women of both ethnicities named general things, like “good nutrition” and “healthy lifestyle,” to reduce breast cancer risk. This included eating more fruits and vegetables, as well as reducing fat and meat intake. Five of the focus groups mentioned quitting smoking to reduce the risk of breast cancer. In half of the groups, women named reducing alcohol consumption, and women in two groups named breastfeeding as a way to reduce one’s risk of breast cancer. Avoiding coffee and caffeine was a popular answer among the Hispanic women. Fruits and vegetables were commonly named as food items that might reduce breast cancer risk.

Exercise practices appeared to be individualized according to each woman’s financial, social, and health situation. All groups recognized the link among exercise, good health, and weight control, and many felt that losing weight could not be achieved with diet or exercise alone. The combination of both was best. Some women exercised to tone and increase their energy levels, not just to lose weight. The most common factor that motivated women to exercise was having a partner with whom to exercise, especially for African-American women.

Walking was the preferred exercise by women in both ethnic groups. Using the gym for exercise was more common among the Hispanic participants. African-American women named a greater variety of barriers to exercise than did Hispanics. One of the most common barriers to exercise was lack of energy and/or restrictive health conditions: “don’t feel up to it” (African-American focus group), “don’t feel good” (African-American focus group), “high blood pressure” (Hispanic focus group), and “hernia” (Hispanic focus group). Another common barrier was lack of time, especially for Hispanics. Lack of time was attributed to work, school, and children to care for. Named in the groups, but not common, were bad weather, no willpower, no money for the gym, ill-fitting shoes, and no room in the house. While women were able to name a long list of exercises, few admitted to regular exercise, although most voiced an interest.

Participants were asked about the kinds of activities in which they engaged to reduce the risk of developing colorectal cancer. Common dietary practices that participants thought might reduce the risk of developing colorectal cancer included reducing or eliminating alcohol, reducing red meat and fat consumption, and eating a balanced diet high in fruits and vegetables. All groups were in agreement that a healthy generally reduces one’s cancer risk. During the discussion of colorectal cancer and healthy diet, fiber was mentioned in two of the Hispanic groups but not by any of the African-American participants.

Other than by modifying their diet, women did not name other ways to reduce their risk for colorectal cancer. Participants were not aware of any medicines, herbs, or vitamins that could reduce risk or prevent cancer. There was very little variation between ethnic groups as to whether women would be interested in taking daily medicines to prevent colon cancer. When presented with the concept, many were skeptical and voiced concerns of medicinal side effects. Many stated that they do not like taking pills (including birth control) for a variety of reasons, but a few thought if it would surely prevent colorectal cancer, they would do it or consider it, especially if they were high risk.

Women were generally unaware of the benefits of multivitamins for colon health. Hispanics, more so than African-American women, voiced a preference for natural or “fresh” vitamins and home remedies from foods rather than pills or medicines.

“I am not a pill taker. I do not like pills. There’s a juice I prepare. I saw it on TV It cleans your colon and your intestine very well. I did it for a week, and that did me a lot of good. It’s carrots, beets, spinach, celery, yellow bell pepper—not the red one— and a bit of parsley. You make it in the juice extractor.” (Hispanic focus group)
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While the activities that participants described were not consciously undertaken to alter their levels of colorectal cancer risk, per se, there was acknowledgment that learning about risk factors which could be modified, including one’s personal level of risk, was important.

Risk Communication Formats

Participants were asked to evaluate four different formats for communicating a woman’s level of personal cancer risk. Numerical, graphic, descrip­tive, and comparative materials were evaluated for their efficacy at communicating the risk of developing breast or colorectal cancer. Materials for the Hispanic groups were translated into Spanish. The risk communication formats evaluated in the focus groups appear.

The first of these, Item 1, showed silhouettes of 100 women, nine of which were darkened. The caption read: In a group of 100 women who are 50 years old, nine will develop breast cancer before they reach the age of 80. Item 2 showed a shaded column of bars on a continuum of low, average, and high, with a second shaded bar beside it indicating “average” and marked “your risk” for breast cancer. Item 3 presented a bar graph with each bar displaying the relative risk of breast cancer for various family histories. Item 4 contained text to represent a doctor telling a patient that her risk of breast cancer is 0.5% and risk for colorectal cancer is 2.0%. The four items were presented to each focus group in the same order. Women were asked to interpret each item and discuss its meaning and effectiveness. For the four risk communication formats, there was little or no difference in opinion between ethnicities.

Item 1 was viewed as unclear, vague, and conveying low risk. Participants did not see themselves as one of the nine women portrayed as being at risk in the group of 100 figures that were displayed. Of the four formats presented, it was viewed as conveying the least amount of useful information. As a result, it was not viewed as effec tive and was the least preferred.
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“It doesn’t tell you anything…It doesn’t say what, who, when, where, why, what.” (African-American focus group)

Item 2 and its bar graph format were viewed as more informative and effective than Item 1. The educational text presented to the right of the bars was viewed by participants as conveying important information about a woman’s level of risk. Women believed that format conveyed a greater risk than did Item 1 but were split as to whether or not they could relate to the message.

“You relate more to being average than you do to being one of the nine.” (African-American focus group)

Item 3 was the most preferred of all the risk communication materials the women reviewed. They described it as easy to understand, educational, and more personal. Participants were able to interpret the graph and easily identified their personal risk based on their family histories.

“This is more personalized. I mean, you can more relate to it as you were saying because it’s the individual level. I would say this is more individual…” (African-American focus group)

“I like this one more. This one explains it better. When the bar is tall, it is greater. When the bar is smaller, it is less.” (Hispanic focus group)

One African-American woman brought up the issue of communicating relative risk in families consisting of nuclear members who are not biologically related or are related through one parent only.

“.. .here, it says if you have a sister, you have a greater risk. Okay, now if the sisters share the same mother or share the same father, in terms of genetics, there’s a lot of questions unanswered. It’s just taking into account that these sisters have the same parents biologically, or do they have different parents biologically?” (African-American focus group)

Item 4 was one of the least-preferred formats. Like Item 1, participants claimed that they were unable to translate its content into practical meaning. They felt that it was complex and did not provide a clear explanation of risk. Many women did not understand which numerical risk percentage (0.5% or 2.0%) was greater. They commented that this format would be better for women who were educated, professional, or “intelligent.”

Of the four approaches to risk communication, participants clearly preferred a visual presentation of level of risk through graphs based on personal risk factors, like family history (Item 3). eriacta 100 mg