By Ashley Hayes
WebMD Health News
Reviewed by Arefa Cassoobhoy, MD, MPH
Oct. 25, 2016 -- When it comes to reducing cancer risk, are doctors not talking or are patients not listening?
More than two-thirds of primary care health professionals responding to a survey (71%) say they start conversations with patients about steps to prevent cancer. But only 27% of patients say their health care professional has had such a discussion with them.
The survey was done by WebMD and its site for health care professionals, Medscape. It questioned 1,508 consumers and 754 primary care doctors, nurse practitioners, and doctor assistants. The WebMD/Medscape survey on consumer and health care professional attitudes toward cancer prevention is part of a public commitment to Vice President Joe Biden's Cancer Moonshot initiative. Cancer prevention and screening are keys parts of the initiative.
Among patients who say their health care professional did discuss cancer prevention steps, those with the biggest disconnects between the two include:
- Using condoms for high-risk sexual behavior: 13% of patients, vs. 69% of health care professionals
- Quitting smoking: 49% of patients, vs. 96% of health care professionals
- Getting vaccines such as hepatitis B and HPV: 25% of patients, vs. 70% of health care professionals
- Family history of cancer: 57% of patients, vs. 90% of health care professionals
But most patients and doctors say they did discuss topics such as screening tests like mammograms or colonoscopies; annual wellness exams; and having a healthy body or losing weight.
Among health care professionals who say they don't discuss cancer prevention with patients, the top reason given was not having time during most appointments (69%).
Most patients (76%) believe it's possible for someone to lower their cancer risk, and 71% say they take steps to do so. Among patients, the most common steps they take include:
- Quit smoking: 83%
- Have an annual wellness exam: 79%
- Get recommended screening tests: 78%
- Limit or avoid alcohol: 71%
- Eat a healthy, balanced diet: 70%
Those who take such steps say they do so for two main reasons: "I simply decided it was important to make these changes" (70%) and "I'm getting older and realized I should take the steps" (64%). In addition, 32% say they decided to after seeing what happens to someone with cancer.
"Our choices are the greatest predictor of our health, so it's great news that people understand there is a lot you can do to lower your chance of developing cancer," says Michael W. Smith, MD, WebMD chief medical editor. "Despite any health decisions you've made in the past, taking control today by losing weight, eating healthy, getting more activity, and cutting back on alcohol will significantly lower your risk of developing cancer."
Nearly 4 in 5 survey respondents (79%) say they have had a close family member with cancer, most often a parent (47%). Not surprisingly, patients with cancer in their family history were more likely to:
- Report higher levels of concern about cancer: 56%, compared with 40% without a family history
- Believe their personal cancer risk is higher: 45%, vs. 15% for those without a family history
- Take steps to lower their cancer risk: 72%, vs. 67% without a family history
Asked whether they've ever experienced a sign or symptom they believed could be cancer, about half of patients (51%) say yes. Nearly all of those (95%) report taking some action:
- 75% made a doctor's appointment.
- 50% looked up information online.
- 20% talked to a friend or family member.
Nearly 2 in 5 (39%) of those who made a doctor's appointment report everything was fine. But 20% of them say they were diagnosed with cancer.
On cancer screening tests, most people -- both women and men -- reported following their doctor's advice to have a test such as a skin exam; a rectal exam for prostate cancer in men; or a colonoscopy or a mammogram for women.
Among those who don't, doctors say the top reasons given were preparing for colonoscopies is unpleasant (71%) and the test itself is unpleasant, might hurt, or be embarrassing (63%). For mammograms, doctors say women tell them the test is unpleasant, might hurt, or be embarrassing (74%) and the women don't believe they need it (49%).
"In addition to healthy lifestyle choices, the No. 1 way to prevent or cure cancer is to find it early," Smith says. "And the best way to do that is through recommended screening tests. When your doctor finds cancer in the early stages, it's much easier to treat and more likely to be cured."
When it comes to cancer research, more than half the WebMD audience (56%) say they think the U.S. devotes too few resources, compared with 39% of doctors.
"Despite major advancements in cancer in recent years, there is still so much we don't know, including how nutrition and lifestyle affect risk," Smith says. "There are many exciting developments on the horizon, from effective treatments with few to no side effects to new, easier ways to find cancer. The only way to bring these ideas to reality and improve lives is through more research."
WebMD Consumer Cancer Attitudes and Behaviors Survey Methods
WebMD's Consumer Cancer Attitudes and Behavior Survey was completed by 1,508 random U.S. desktop and mobile WebMD site visitors on Sept. 21-30, 2016. All visitors had an equal probability of answering the survey. The sample represents the WebMD.com online population with a margin of error of ± 2.55% at a 95% confidence level, using a point estimate (a statistic) of 50%, given a binomial distribution.
Medscape Cancer Attitudes and Behaviors Clinician Survey Methods
The Medscape Cancer Attitudes and Behavior Clinician Survey was completed by 754 primary care clinicians who have been active on Medscape in the past 12 months. The survey was fielded Sept. 21-Oct. 5, 2016, via email invitation to include doctors (n=574), doctor assistants (n=80), and nurse practitioners (n=100). The specialty practice areas allowed to answer the survey were family medicine (n=361), internal medicine (n=233), and obstetrics/gynecology (n=160). This sample represents the described Medscape active clinicians in primary care with a margin of error for this sample of ± 3.63%, at a 95% confidence level, using a point estimate (a statistic) of 50%, given a binomial distribution.
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SOURCES: WebMD Consumer Cancer Attitudes and Behaviors survey, Sept. 21-30, 2016. Medscape Cancer Attitudes and Behaviors Clinician survey, Sept. 21-Oct. 5, 2016. Michael W. Smith, MD, WebMD chief medical editor.
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