What Women Don't Know About Cancer

By Salynn Boyles
WebMD Medical News

Oct. 26, 2007 -- Nearly two-thirds of women mistakenly believe having no family history of cancer means they have a low risk of developing the disease, and most do not know that oral contraceptive use is protective against ovarian and uterine cancer, a new survey shows.
Commissioned by the American College of Obstetricians and Gynecologists (ACOG), the poll results were released Friday to coincide with the launch of a new web-based guide designed to help women better understand their cancer risk.
ACOG past president Douglas W. Laube, MD, says the survey findings reveal a "worrisome gap in women's knowledge about cancer."
"This knowledge gap, as well as their fears about cancer, may be putting women at risk," he said at a Friday morning media briefing.
Among the highlights from the survey:
Two out of three women did not know that the vast majority of cancers occur in women with no family history of the disease. Only about 5% to 10% of breast cancers are thought to be hereditary, according to the American Cancer Society.
"While we know that having a family history of cancer is a risk factor, the fact is that most cancers occur in people with no family history of this disease at all," Laube says. "So those without a family history cannot assume that they are not at risk."
Only 11% of women knew that taking oral contraceptives is associated with a reduced risk of ovarian, uterine, and possibly colorectal cancer.
"Unfortunately the pill remains one of the best kept secrets in medicine," Laube says, adding that oral contraceptive use is still linked in many women's minds with an increased risk of breast cancer, even though many studies have found little or no association.
Only about half of the women surveyed felt they were doing enough to reduce their cancer risk, and 10% said they had done nothing to reduce their risk in the past year.
Almost one in three women (29%) reported that they did not see a health care provider on a regular basis and had not had a Pap test or mammogram during the previous year.
About a third of women without regular medical care cited lack of health insurance or other economic barriers as the reason.
"The greatest potential to further reduce cancer deaths in women will come from efforts to improve screening and access to preventive health care, particularly for women without insurance," Laube says.
The online survey conducted by Harris Interactive included 1,664 adult women aged 18 and older and took place Oct. 1 through Oct. 3, 2007.
New Colorectal Cancer Guidelines
Also on Friday, ACOG released new guidelines identifying colonoscopy as the preferred screening method for colorectal cancer.
The group is the first major health care organization to do this.
The guidelines call for most average-risk women to begin screening at age 50, with repeat screenings every 10 years or as needed. Women should be screened earlier if they have a family history of the disease or of adenomatous polyps, a personal history of colorectal cancer or polyps, or inflammatory bowel disease.
Advantages of colonoscopy over other screening methods include its ability to visualize the entire colon and to remove potentially dangerous polyps that could become malignant.
"While we want ob-gyns to encourage this method, they should still discuss the advantages and limitations of the other screening options with their patients," says Carol Brown, MD, of Memorial Sloan-Kettering Cancer Center. "The bottom line is we want women to get tested by whichever method they are most likely to accept and follow through with."
Lung Cancer Bucking the Trend
ACOG's web guide titled "Protect and Detect: What Women Should Know About Cancer," was designed to educate women about the cancers that affect them most, including breast, cervical, colorectal, lung, ovarian, and uterine cancers.
While the death rate from most of these cancers has either declined or remained steady in recent years, lung cancer deaths among women has climbed.
Fully 80% of lung cancers in women are caused by smoking, and 5% to 10% may be due to 'passive' exposure to cigarette smoke, Sharon Phenlan, MD, professor of obstetrics and gynecology at the University of New Mexico School of Medicine, said Friday.
Though more women get more breast cancer than lung cancer, far fewer breast cancer patients die. In 2007, the American Cancer Society estimates that 70,880 women will die of lung cancer, compared with 40,460 who will die of breast cancer.