Perceived ambiguity about cancer prevention recommendations: associations with cancer-related perceptions and behaviours in a US population survey

Background: Health information reaching the public today is often characterized by what decision theorists have termed 'ambiguity'- i.e. uncertainty regarding the information's reliability, credibility or adequacy. This is a critical problem, as growing research suggests that ambiguity has important effects-promoting pessimistic judgments about risks and potential outcomes of risk-reducing behaviours, and lowering adoption of these behaviours. However, little is known about the public's perceptions of ambiguity in the health information domain, the effects of these perceptions, and the factors that influence these effects. Objective: To examine associations between perceived ambiguity regarding cancer prevention recommendations and prevention-related perceptions and behaviours, and to explore how these associations differ by cancer type. Study design and participants: Cross-sectional analysis of data on 4070 adults participating in the 2005 US Health Information National Trends Survey. Main variables and outcome measures: We examined associations between perceived ambiguity about colon, skin and lung cancer prevention recommendations and two main outcome variables: (i) risk-related cognitions (perceived cancer risk and preventability, cancer-related worry) and (ii) risk-modifying behaviours (colon cancer screening, sunscreen use and smoking abstinence). Results: Perceived ambiguity was inversely associated with perceptions of the preventability of all three cancers, and with cancer-specific risk-modifying behaviours including sigmoidoscopy-colonoscopy testing, sunscreen use and smoking abstinence. Relationships with cancer risk perceptions and worry varied across different cancer types. Conclusions: Perceived ambiguity about cancer prevention recommendations has significant and predictable associations with cancer prevention-related cognitions and behaviours, and some associations differ by cancer type. These findings have implications for future research and communication efforts.