Being ‘at-risk’ for developing cancer: cognitive representations and psychological outcomes

This study investigated cognitive representations and psychological effects of being ‘at-risk’ for cancer. Perceived personal risk for cancer and causal attributions for cancer were measured in four groups: women identified as carriers of mutations in breast/ovarian cancer genes BRCA1 BRCA2, habitual smokers, X-ray technicians, and an average-risk group. Despite differences in awareness of their risk status and perceived risk for cancer, the groups did not differ in health anxiety, cancer worry interference, and self-assessed health. Motivated reasoning processes were identified as potential strategies used by individuals at-risk to regulate levels of psychological distress. Evidence for biased risk perceptions and unrealistic optimism were found among smokers, and patterns indicative of self-enhancement through self-assessments and defensive discounting of cancer causal attributions were found in the genetically susceptible group. These findings highlight the role of cognitive representations in adjustment to being at-risk for cancer.