Purpose of the Study: Inaccurate perceptions of risk compromise informed decision-making and may have important behavioral and psychological consequences. We examined the perception of breast, cervical, and colorectal cancer risk and compared to the actual risk and the screening behavior of a sample of women from four ethnic groups.

Methods: Women, aged 50 to 80, who hade made at least one visit to a primary care physician in the past two years were recruited from ambulatory practices. Trained interviewers administered an initial screening telephone survey and a follow-up in-person interview in English, Spanish or Chinese. Multivariate regression models examined ethnic differences in risk perception and screening, controlling for education, age, income, previous cancer history, and family history of cancer.

Results: To date, 760 women completed the survey; 316 non-Latino White (41.6%), 121 African-American (15.9%), 121 Latina (15.9%), 178 Asians (23.4%), and 24 other (3.2%). Multivariate results showed that compared to White women, Latina women perceived 12.4% higher risk of breast cancer (P<.001), 17.8 % higher risk of cervical cancer (P<.001) and 15.2% higher risk of colorectal cancer (P<.001). African American perceived 6.5% higher risk of breast cancer (P<.05), 8.6% higher risk of cervical cancer (P< .01), and 8.2% higher risk of colorectal cancer (P, >01), compared to non-Latino White women. Asian women perceived 5.5% lower risk of breast cancer (P< .05) and no significant difference in cervical and colorectal cancer risk, compared to non-Latino White women. For any cancer, having a college degree was related to a lower cancer risk perception (-5.4%, P<.05) and family history of cancer was related to about 9.8% higher cancer risk perception (P< .001). Women who have had a colonoscopy reported about 8.5% higher colorectal cancer risk perception (P<.001). There was no significant relationship between cervical or breast cancer screening and risk perception.

Conclusion: All women did not have an accurate understanding of their cancer risk. Yet, ethnic differences persisted in cancer risk perception even after controlling for education, age, income, and cancer history (self and family). Only colonoscopy screening was positively related to having a higher colorectal cancer risk perception. In order to help clinicians communicate with patients about risk information, we will examine whether using traditional percentage and numeracy information is effective in all diverse populations.