Cancer Control Research5R03CA101529-02
Klein, William M P
ACCEPTANCE OF COLORECTAL CANCER RISK FACTOR FEEDBACK
DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is now the second leading cause of cancer-related death in the United States. Current guidelines suggest that individuals aged 50 and over (40 and over with high genetic risk) engage in regular screening (using FOBT, colonoscopy, and sigmoidoscopy). Nevertheless, 65 percent of individuals in this age group are off-schedule for CRC screening. It is important to raise CRC risk perceptions among such individuals given that risk perceptions are a predictor of screening. One promising method of doing so is to show people that their comparative risk (relative to others of the same age and sex) could be lower if they screen. This approach is supported by a wealth of research showing that people are particularly responsive to social comparison information. However, accompanying this interest in comparative information is a desire to judge one's comparative risk favorably, a desire that could lead to defensive processing of the threatening information. Such defensiveness can be reduced by giving recipients a chance to reflect on positive aspects of their health (a technique called "self-affirmation"), which protects their self-esteem and permits more effective (and less defensive) processing of comparative information. This study will assess the impact of comparison information and self-affirmation on perceptions of absolute and comparative risk as well as on worry, screening intentions, and subsequent screening, and will also examine what defensive strategies people use when getting comparison information without a selfaffirmation opportunity. The findings will be useful both in the development of sound and theoretically-based intervention strategies for encouraging CRC screening, and in the development of self-affirmation theory and social comparison theory - two theories that are central to the empirical study of self-evaluation but which are rarely examined in the same investigation.