Colorectal cancer lifetime risk accuracy and behavior change intentions before and after risk assessment



This study examined accuracy of perceived lifetime risk of colorectal cancer prior to and following receipt of cancer risk assessment (CRA) feedback among average risk adults. The specific aims were to identify predictors of improved risk perceptions and assess whether improvement in perceived lifetime risk accuracy was associated with changes in behavioral intentions for physical activity, diet, and colorectal cancer screening.


Adults with no known history of colorectal cancer (n = 419) were enrolled in a study examining the impact of colorectal cancer risk assessment feedback. Risk perceptions and behavioral intentions were ascertained before and after risk assessment administration.


Accuracy of perceived lifetime risk significantly improved after CRA feedback, often as a result of lowered perceived risk. Those who were White, married, attended some college, and had higher numeracy were more likely to report accurate lifetime risk post-CRA. No differences in behavioral intentions were reported between those with and without improved accuracy.


Minorities and those with low numeracy were less likely to report accurate perceptions post-CRA. Although improved accuracy was not associated with increased behavioral intentions as expected, it is reassuring that intentions for health behaviors were not inhibited as perceived risk decreased.

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Financial support for this study was provided in part by a predoctoral training award from the Susan G. Komen Foundation (Grant No. GTDR14302086) and a National Cancer Institute T32 award (Grant No. 2T32CA093423).

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Correspondence to Carrie A. Miller.

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Miller, C.A., Barnes, A.J., Fuemmeler, B.F. et al. Colorectal cancer lifetime risk accuracy and behavior change intentions before and after risk assessment. Cancer Causes Control (2021).

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  • Risk communication
  • Colorectal cancer
  • Risk perception
  • Behavioral intention