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How to Better Communicate Cancer Risk to Patients

How to Better Communicate Cancer Risk to Patients

Both physicians and public health specialists can learn valuable lessons about communicating cancer risks from the experiences of those engaged in environmental risk communications, said Frank Baker, phd, a senior official of the American Cancer Society (ACS).

"An emergent theme from environmental risk communications is the importance of two-way communications, which has important implications for health risk communications as well," said Dr. Baker, who heads the ACS programs in behavioral and psychosocial research. He spoke at the ACS' National Conference on Cancer Prevention and Early Detection, sponsored, in part, by the Centers for Disease Control and Prevention.

The two areas of risk communications, environment and health, have separate research literature that overlap in certain areas, particularly occupational health and safety. Yet, Dr. Baker said, they yield somewhat different perspectives on how to communicate with the public.

The Importance of a Clear Message

One important message from the environmental field is that the public "doesn't necessarily accept comparisons of voluntary and involuntary risks," he said. And a person's cognitive framework plays a major role in how they internalize risk messages.

"Psychologists have found that we live in a world of our own perceptions and that we perceive things as hazardous depending on these concepts," Dr. Baker noted. "People are influenced by these cognitive limitations and these judgmental rules, and we need to be aware of that as we structure our communications."

Whether planning an antismoking public service campaign or trying to persuade a two-pack-a-day cigarette addict to kick the habit, one needs to tailor the message to the knowledge level, concerns, age, and communication-processing capabilities of the message's target. "This is important in patient communications," he said.

One Style Is Not Enough

He described research he conducted at Johns Hopkins University prior to joining ACS, during which he examined the ways the physicians communicate risk-benefit information to people who are potential bone marrow recipients. Rather than tailoring the information, Dr. Baker said, the physicians tended to resort to a "one-size-fits-all mentality," which reduced the effectiveness of their communication efforts.

"You need to recognize that people have different abilities to process information, and certainly in anxiety provoking situations," Dr. Baker said. This holds also for patients' willingness and abilities to pay attention and focus on the words and message aimed at them. He quoted a friend who studies doctor-patient communications as saying: "Patients hear half of what the physician says, and then remember half of that."

Health communicators often rely on fear to convey their message, but fear alone is not enough, Dr. Baker said. He showed a familiar poster, one with a healthy lung on the left and a dirty, damaged smoker's lung next to it. "Here we certainly have fear arousal, but it doesn't tell you what you can do about it," he said. Good occupational health communications, however, leave little to the imagination or for misinterpretation, he said, because they not only emphasize risk but "what you can do about it."

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