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Laypersons' Responses to the Communication of Uncertainty Regarding Cancer Risk Estimates

Author

Listed:
  • Paul K. J. Han

    (Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, hanp@mail.nih.gov)

  • William M. P. Klein

    (Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania)

  • Thomas C. Lehman

    (Center for Social Marketing and Behavior Change, Academy for Educational Development, Washington, DC)

  • Holly Massett

    (Operations Research Office, National Cancer Institute, Bethesda, Maryland)

  • Simon C. Lee

    (Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland)

  • Andrew N. Freedman

    (Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland)

Abstract

Objective . To explore laypersons' responses to the communication of uncertainty associated with individualized cancer risk estimates and to identify reasons for individual differences in these responses. Design . A qualitative study was conducted using focus groups. Participants were informed about a new colorectal cancer risk prediction model, and presented with hypothetical individualized risk estimates using presentation formats varying in expressed uncertainty (range v. point estimate). Semistructured interviews explored participants' responses to this information. Participants and Setting . Eight focus groups were conducted with 48 adults aged 50 to 74 residing in 2 major US metropolitan areas, Chicago, IL and Washington, DC. Purposive sampling was used to recruit participants with a high school or greater education, some familiarity with information technology, and no personal or immediate family history of cancer. Results . Participants identified several sources of uncertainty regarding cancer risk estimates, including missing data, limitations in accuracy and source credibility, and conflicting information. In comparing presentation formats, most participants reported greater worry and perceived risk with the range than with the point estimate, consistent with the phenomenon of ``ambiguity aversion.'' However, others reported the opposite effect or else indifference between formats. Reasons suggested by participants' responses included individual differences in optimism and motivations to reduce feelings of vulnerability and personal lack of control. Perceptions of source credibility and risk mutability emerged as potential mediating factors. Conclusions . Laypersons' responses to the communication of uncertainty regarding cancer risk estimates differ, and include both heightened and diminished risk perceptions. These differences may be attributable to personality, cognitive, and motivational factors.

Suggested Citation

  • Paul K. J. Han & William M. P. Klein & Thomas C. Lehman & Holly Massett & Simon C. Lee & Andrew N. Freedman, 2009. "Laypersons' Responses to the Communication of Uncertainty Regarding Cancer Risk Estimates," Medical Decision Making, , vol. 29(3), pages 391-403, May.
    • Handle: RePEc:sae:medema:v:29:y:2009:i:3:p:391-403
    DOI: 10.1177/0272989X08327396
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    References listed on IDEAS

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      • Fotios Petropoulos & Daniele Apiletti & Vassilios Assimakopoulos & Mohamed Zied Babai & Devon K. Barrow & Souhaib Ben Taieb & Christoph Bergmeir & Ricardo J. Bessa & Jakub Bijak & John E. Boylan & Jet, 2020. "Forecasting: theory and practice," Papers 2012.03854, arXiv.org, revised Jan 2022.
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    3. Toshio Fujimi & Masahide Watanabe & Hirokazu Tatano, 2021. "Public trust, perceived accuracy, perceived likelihood, and concern on multi-model climate projections communicated with different formats," Mitigation and Adaptation Strategies for Global Change, Springer, vol. 26(5), pages 1-20, June.
    4. Mark Harrison & Carlo A. Marra & Nick Bansback, 2017. "Preferences for ‘New’ Treatments Diminish in the Face of Ambiguity," Health Economics, John Wiley & Sons, Ltd., vol. 26(6), pages 743-752, June.

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