br www ajpmonline org Table Demographic and
www.ajpmonline.org Table 1. Demographic and Socioeconomic Characteristics According to FHCA, Including FHCA by Cancer Type in Males Without Cancer (KoGES 2004−2013)
Note: Values are n (%) unless otherwise indicated. Boldface indicates statistical significance (p<0.05). a
bp-values were determined using x2 test, excluding missing data. Proportions of covariates were compared between those who Cell Counting Kit-8 (CCK-8) cck8 cck-8 had FHCA or each cancer type of FHCA to those without any FHCA. cChronic diseases included the diagnosis of any kind of chronic diseases by a physician in the past.
FHCA, family history of cancer; KoGES, Korean Genome and Epidemiology Study.
Table 2. Demographic and Socioeconomic Characteristics According to FHCA, Including FHCA by Cancer Type in Females Without Cancer (KoGES 2004−2013)
No FHCA Any FHCAa Stomach Liver Colorectum Breast Cervix Lung Thyroid Others
Number of children
p-value b —
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those without any
type of FHCA to
or each cancer
those who had FHCA
0 (0.0) 0.003 . fiAnyFHCAdenedasthosewhohadanytypeoffamilyhistoryofcancer. compared between Chronicdiseasesincludedthediagnosisofanykindofchronicdiseasesbyaphysicianinthepast. historyofcancer;KoGES,KoreanGenomeandEpidemiologyStudy.
test, excluding missing data. Proportions of covariateswere
Missing p-value Note: Values a b c FHCA, family
such as less smoking and being less obese. Although the chronologic order between behavioral change and FHCA experience is unknown, former smoking and alcohol con-sumption rates in people with and without an FHCA were used as surrogate indicators of behavioral changes. In male participants, former smoking rates were higher in those with an FHCA compared to those without an FHCA (42.0% and 39.0%, respectively). In females, for-mer smoking rates were similar regardless of FHCA (1.2% and 1.5%, respectively). The former alcohol con-sumption rate was not different according to FHCA in both males and females (7.0% and 7.0% in males, 2.0% and 2.4% in females; data not shown). Previous studies comparing health behaviors by FHCA did not analyze
separately by sex, which might be a possible cause of the nonsignificant association.14,24 One study found that hav-
ing FHCA was associated with a higher intention to quit smoking, even though personal history of cancer did not affect smoking cessation efforts. This suggests that people with FHCA could be a target population for health inter-vention programs, and increased perception of cancer risk may be an intermediate result.27
Several previous studies have shown that, in the gen-eral population, females have better health behaviors than males.27−29 In the current study population, most of the unhealthy behaviors, including current smoking, drinking alcohol, and obesity, showed lower prevalence in females than in males, irrespective of an FHCA and types of FHCA. Although several studies have shown that women are more willing to actively search health-related information30 and change their health behav-iors,31 females with FHCA showed worse health behav-iors than those without FHCA in the current study. One possible explanation could be the “choice overload hypothesis,” which means that too many choices may cause indecisiveness.32 Females seek health-related infor-mation more actively than males, especially when they have known risk factors33 and, therefore, females could be overwhelmed by the possible choices of lifestyle mod-ifications. Another possible explanation could be that as the health behaviors of females are generally better than those of males, females who present unhealthy behaviors may not have much improvement potential in changing their behaviors, and those who have an FHCA may have higher behavioral risks aggregated within the family. Conversely, physicians’ recommendations may be important for improving health behaviors, yet recom-mendations from clinicians for women with FHCA may focus more on cancer screening than on changing life-style behaviors.26 A previous study also showed that women with a strong FHCA of the breast were more likely to uptake medical care provided by physicians, such as screening or medication, rather than engage in
Table 3. Comparison of Health Behaviors According to FHCA, Including FHCA by Cancer Type in Males Without Cancer (KoGES 2004−2013)
Note: Boldface indicates statistical significance (p<0.05) compared to the reference groups. aReference group was those with no cancer diagnosis by a physician and also with no FHCA at the time of survey.