Objective: To assess whether public understandings of inherited predisposition to colorectal cancer may undermine preparedness to respond to preventive messages. Methods: Structured in-depth interviews with 31 women and men, aged 50 years and over. Results: Most participants viewed genetic factors as prompts for taking preventive measures rather than as reasons for fatalism and inaction. They were optimistic about the potential benefits of new developments in cancer prevention and treatment. Conclusions: There was little evidence of perceived genetic determinism in relation to colorectal cancer, but there were some significant misunderstandings about causes, prevention and treatment. These findings have important implications for public health communications about the contribution of genetics to cancer causation.

Keywords:
Colorectal cancer, Public understanding, Risk behaviour, Health communication
1.
International Agency for Research on Cancer: IARC Handbooks of Cancer Prevention: Weight Control and Physical Activity. Oxford, Oxford University Press, 2002, vol 6.
2.
Gotay CC: Behavior and cancer prevention. J Clin Oncol 2005;23:301–310.
3.
Prentice RL, Willett WC, Greenwald P, Alberts D, Bernstein L, Boyd NF, Byers T, Clinton SK, Fraser G, Freedman L, Hunter D, Kipnis V, Kolonel LN, Kristal BS, Kristal A, Lampe JW, McTiernan A, Milner J, Patterson RE, Potter JD, Riboli E, Schatzkin A, Yates A, Yetley E: Nutrition and physical activity and chronic disease prevention: research strategies and recommendations. J Natl Cancer Inst 2004;96:1276–1287.
4.
Slattery ML, Potter JD: Physical activity and colon cancer: confounding or interaction? Med Sci Sports Exerc 2000;34:913–919.
5.
Lynch HT, de la Chapelle A: Hereditary colorectal cancer. N Engl J Med 2003;348:919–932.
6.
Lichtenstein P, Holm NV, Verkasalo PK, Iliadou A, Kaprio J, Koskenvuo M, Pukkala E, Skytthe A, Hemminki K: Environmental and heritable factors in the causation of cancer – analyses of cohorts of twins from Sweden, Denmark, and Finland. N Engl J Med 2000;343:78–85.
7.
Thomas RJ, Clarke VA: Colorectal cancer: a survey of community beliefs and behaviours in Victoria. Med J Aust 1998;169:37–40.
8.
Camilleri-Brennan J, Steele RJC: A comparative study of knowledge and awareness of colorectal and breast cancer. Eur J Surg Oncol 1999;25:580–583.
9.
Yardley C, Glover C, Allen-Mersh TG: Demographic factors associated with knowledge of colorectal cancer symptoms in a UK population-based survey. Ann R Coll Surg Engl 2000;82:205–209.
10.
Wong NY, Nenny S, Guy RJ, Seow-Choen F: Adults in a high-risk area are unaware of the importance of colorectal cancer: a telephone and mail survey. Dis Colon Rectum 2002;45:946–504.
11.
Graham ID, Logan DM, Hughes-Benzie R, Evans WK, Perras H, McAuley LM, Laupacis A, Stern H: How interested is the public in genetic testing for colon cancer susceptibility? Report of a cross-sectional population survey. Cancer Prev Control 1998;2:167–172.
12.
Jalleh G, Donovan RJ: Bowel Cancer vs. Heart Disease Appeals in Promoting Physical Activity. Perth, Centre for Behavioural Research in Cancer Control, Division of Health Sciences, Curtin University of Technology, 2004.
13.
Weitzman ER, Zapka J, Estabrook B, Goins KV: Risk and reluctance: understanding impediments to colorectal cancer screening. Prev Med 2001;32:502–513.
14.
Mesters I, Ausems A, De Vries H: General public’s knowledge, interest and information needs related to genetic cancer: an exploratory study. Eur J Cancer Prev 2005;14:69–75.
15.
Lerman C, Shields AE: Genetic testing for cancer susceptibility: the promise and the pitfalls. Nat Rev Cancer 2004;4:235–241.
16.
Kinney AY, DeVellis BM, Skrzynia C, Millikan R: Genetic testing for colorectal carcinoma susceptibility – focus group responses of individuals with colorectal carcinoma and first-degree relatives. Cancer 2001;91:57–65.
17.
Collins V, Meiser B, Gaff C, St John DJ, Halliday J: Screening and preventive behaviors one year after predictive genetic testing for hereditary nonpolyposis colorectal carcinoma. Cancer 2005;104:273–281.
18.
Wright AJ, Weinman J, Marteau TM: The impact of learning of a genetic predisposition to nicotine dependence: an analogue study. Tob Control 2003;12:227–230.
19.
Khoury MJ, Yang Q, Gwinn M, Little J, Dana Flanders W: An epidemiologic assessment of genomic profiling for measuring susceptibility to common diseases and targeting interventions. Genet Med 2004;6:38–47.
20.
Nelkin D, Lindee MS: The DNA Mystique: The Gene as a Cultural Icon. New York, WH Freeman and Company, 1995.
21.
Viswanath K, Breen N, Meissner H, Moser RP, Hesse B, Steele WR, Rakowski W: Cancer knowledge and disparities in the information age. J Health Commun 2006;11(suppl 1):1–17.
22.
Condit C, Parrott R, Harris T: Laypeople and behavioral genetics; in Parens E, Chapman AR, Press N (eds): Wrestling with Behavioral Genetics: Science, Ethics, and Public Conversation. Baltimore, Johns Hopkins University Press, 2005, pp 286–308.
23.
Collins FS: Shattuck lecture – medical and societal consequences of the Human Genome Project. N Engl J Med 1999;341:28–37.
24.
Hicken B, Tucker D: Impact of genetic risk feedback: perceived risk and motivation for health protective behaviours. Psychol Health Med 2002;7:25–36.
25.
Henneman L, Timmermans DR, Van der Wal G: Public experiences, knowledge and expectations about medical genetics and the use of genetic information. Community Genet 2004;7:33–43.
26.
Gerend MA, Aiken LS, West SG, Erchull MJ: Beyond medical risk: investigating the psychological factors underlying women’s perceptions of susceptibility to breast cancer, heart disease, and osteoporosis. Health Psychol 2004;23:247–258.
© 2008 S. Karger AG, Basel
2008
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.