Cancer anxiety and the perception of risk in alarmed communities.

Cancer is a significant public health topic and is frequently a factor in public reactions to environmental hazards. It may be reasonable to suggest that a unique form of health anxiety exists - one specific to cancer. In this article, we explore a measure of cancer anxiety that has applicability to risk perception in the specific context of communities that are alarmed over suspect cancer rates thought to be associated with environmental hazards. A literature search was used to identify survey questions previously used to measure cancer worry, fear, anxiety, etc. A list of 24 items was employed in a mail survey sent to 30 communities in which cancer rates were under investigation (part of a broader study). An analysis of the dataset of 1,111 responses yields two versions of a cancer anxiety scale: one an additive combination of 21 items (alpha= 0.77) and the other a two-factor model consisting of nine- and four-item subscales (alpha= 0.74 and 0.69). The resulting scales are evaluated for their ability to predict perception of risk from the environmental hazards in these cases. Controlling for age, sex, and cancer status, the scales explain between 2% and 10% of risk perception (full R(2) values ranging from 0.17 to 0.24). Given the range of concepts required to model risk perception, we conclude that this measure of cancer anxiety is sufficiently reliable and robust to be recommended for use in circumstances involving hazards associated with cancer. Other uses and further development of the measure are discussed.