Correlates and predictors of absolute and comparative perceived risk of colorectal cancer.

B30

Health behavior theories suggest that individuals who perceive greater personal cancer risk will be more likely to initiate a behavior change. Additionally, meta-analyses have documented a small, but direct effect of perceived risk on increased cancer screening use. However, most research to identify factors that influence perceptions of risk has been cross-sectional. We used longitudinal data to examine the stability of cross-sectional correlates and prospective predictors of two measures of perceived risk to colorectal cancer (CRC). We analyzed baseline and 2-week follow-up survey data from a preliminary sample (N = 599) of adults with no history of CRC, aged 50-64 years, participating in a behavioral intervention trial. Baseline predictors included study group, demographics, health status, health behaviors, CRC beliefs, perceptions of CRC risk factors, and attributions for personal CRC risk. For absolute perceived risk (likelihood of developing CRC), attributions of CRC risk, beliefs about age as a CRC risk factor, CRC worry, and general health were significant correlates; however, only baseline worry and general health were significant predictors of 2-week perceived risk when baseline perceived risk was included in the model. For comparative perceived risk (CRC risk likelihood compared to others the same age and sex), although attributions of CRC risk were significant correlates, only general health remained a significant predictor in prospective analysis. Race differences were found in prospective analyses only, and family history of CRC was a significant predictor of comparative perceived risk only. These results suggest that individuals' attributions of personal CRC risk strongly influence their overall perceived risk, but may not be stable predictors over time. No previous studies have controlled for such attributions. Future analyses will examine changes in attributions of risk along with changes in perceptions of CRC risk to identify effects of the behavioral intervention and to inform future cancer risk communications. Messages that target individuals' perceived causes of CRC risk may more effectively influence perceptions of personal susceptibility and motivate cancer screening behavior. These results also support earlier evidence against combining absolute and comparative measures of perceived risk given their association with different factors.