Emily Hartung and Wendy Birmingham, Psychology

Introduction

Cancer is the second leading cause of death in the United States, yet many people are not aware of their own personal familial risk. This may be especially true in younger individuals in the population. According to the American Cancer Society, over 1.5 million Americans will be diagnosed with cancer and over 500,000 cancer deaths will occur this year. Cancer remains the second most common cause of death in the United States, accounting for nearly 1 in every 4 deaths. Survival rates vary by type and stage at diagnosis but early detection through screening improves survival odds and healthier behaviors may reduce risk. Additionally, many lifestyle choices such as diet, exercise, sun exposure, alcohol use, smoking, and drug avoidance can influence the likelihood of cancer. Personal knowledge of cancer family history can aid an individual in making healthy lifestyle choices. This study is an investigation of the relative accuracy of family cancer history knowledge in a pre-screening population (younger than 35). We determined whether participant’s knowledge of their personal family cancer history is accurate in comparison with reports from other family members. Younger individuals may not be aware of their own family cancer history and thus may not be aware of the need to alter lifestyle behaviors and increase cancer screening behavior in order to decrease cancer risk. We examined whether family cancer history (and therefore personal cancer risk factors) is associated with screening and lifestyle behaviors. We also examined the individual’s perceptions of their spouse’s influence on the participant’s lifestyle behavior and if there is an association between perceptions of spousal influence and relationship quality. Previous research indicates this may be the case, however, less is known regarding relationship quality, spousal influence and cancer-preventative behavior.

Methodology

Participants were recruited through SONA (an online research management system) and through fliers posted on campus. Potential participants were screened via Qualtrics (online surveys) and eligible participants were asked to complete demographic information and relationship quality information. In order to assess family cancer history knowledge each participant completed a questionnaire detailing their knowledge of their family cancer history which included assessing type of cancer, age at diagnosis and relationship of the participant to the cancer case. Participants were then directed to contact a family relative to verify the information they had provided. Participants brought this information with them to their lab session. In addition to the questionnaires and family cancer history information, we conducted one-on-one interviews with each participant in order to provide rich data regarding participants’ attitudes regarding the information they received from their relative and ways their spouse may influence them to make healthier lifestyle choices.

Results

We have surveyed and interviewed 40 of our anticipated 60 participants. Our sample consisted of 19 males and 21 females with a age range from 20 to 33 (M = 24). Most of our sample was Caucasian (91%), and educated with 54.1% reporting partial college, 32.4% reported as college graduates and 13.5% reporting at least some graduate level or professional school education Most reported attending church at least monthly (91.9%). As part of the interview, participants’ were asked if the knowledge about their family cancer history was accurate in comparison with reports from other family members. Out of the 40 individuals interviewed, 30 had learned something new (75%). “New” can be translated as anything from a new case of cancer in the family, the age of the cancer diagnosis or what type of cancer a family member had, See Table 1.

Cancer Diagnosis	Age of Diagnosis	Type of Cancer
“I didn’t know my grandma had had mast cell carcinoma, just basic skin cancer. That was a surprise to me”	“No, I knew approximately. I thought it was 64, but it was 63.”	“I found out exactly what type of cancer my grandpa had.”
“I didn’t know that my grandma had cancer or my aunt.”	“No, maybe just the age.”	“Yes, I found that my grandmother actually had two different types of cancer.”
“The only thing that was, surprising was I didn’t know my grandpa had had bone cancer.”	“I didn’t know their ages. I didn’t know which one happened first, I didn’t know that for my grandpa, I didn’t know that the throat cancer happened before the skin cancer. I thought it was the other way around.”	“And then I didn’t know the details of my grandparents, both had gotten cancer. ….and I didn’t know the specific details other then they had had cancer. So that was newer information.”
“Yeah, one of my uncles had stomach cancer and I didn’t know about that.”	“Well the only person on the survey that has had cancer is my one uncle and I… it was 16 years old and I did know that.”	“I knew who in my family already had cancer, there were just a couple that I didn’t really know what types they had.”
“I didn’t know that my grandma had breast cancer in her life.”	“I knew the diagnoses and I knew the general ages but not exact years.”

Discussion

In this pre-screening population, 75% learned something new about their family cancer history. We also asked these individuals about general screening knowledge and the recommended ages for certain cancer screening ages (breast, prostate, and colon). Many did not know the required ages for screening. The purpose of our study was to ascertain whether younger individuals had an accurate knowledge of their own personal family cancer history. Our results clearly show that in a younger population, individuals often do not have accurate information. Three-quarters of our participants learned new information when they contacted a knowledgeable relative. Understanding one’s own personal risk through family history can aid individuals in making healthier choices, including early screening decisions if necessary. We are still in the process of collecting data. After data collection is complete we will examine whether spousal influence and relationship quality factor into lifestyle decisions that participants are currently making.

Conclusion

Cancer remains a leading killer of both men and women in the U.S. While some studies have examined family history awareness in at-risk populations, there are no studies we are aware of focusing on familial cancer risk awareness, and spousal influence on lifestyle behaviors in a younger population. Knowledge of personal risk through family history would be advantageous for both the individual and the spouse in this younger population as a majority of preventative measures could be taken before an individual reaches the average population cancer screening age. Our findings will serve as a springboard for novel relationship process interventions to increase lifestyle and screening behavior in this younger population.