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Research Question

What is the association between cancer screening behaviors and family history?

(P) Population: The target population includes adult females between the ages of twenty-five and fifty-five, living in the developed countries. The population group that is being studied consists of white people, African Americans, Asians, and Africans. The test subjects should have the members of their families who have or had cancer.

(I) Indicator: The test subjects were exposed to relevant and proven information concerning the causes of cancer, and the information on how genetics are a part of cancer. The information on genetics and cancer discovery is shown to patients to determine their reaction to the received information.

(C) Comparators: The subjects will be compared to those people that do not have any history, no family member or no relative who has or ever had cancer. The study compares the lifestyles of both types of participants with the aim to improve the accuracy of the research study.

(O) Outcomes: The study outcomes include an increase in anxiety of the subjects from the possibility of getting cancer. There is a continuous increase in the frequency of checking for cancer cells within ones body. Subjects improve lifestyle about avoiding the known carcinogenic foods and materials. The pressures of cancer could cause severe depression due to the fear of getting the disease. Subjects may have certain sleep problems, excessive worrying, and chronic indigestion due to the anxiety and panic attacks.

Eligibility Criteria

Eligibility criteria refer to the factors considered and the characteristics the subjects should have to be able to be a part of the study. The subjects should have good knowledge and understanding of the English language. The subjects should be the human beings. The subjects should not be suffering from serious mental illnesses, such as insanity and permanent amnesia. The participants should all be females.


A predetermined search and analysis criteria are used to get the necessary information to be used. The search criteria take into account the subjects religious affiliation to avoid discrimination. There is the use of a diverse group of participants to get the required information from all types of people. There is the use of electronic database search approach to get the accurate information on carcinogens and the relationship between cancer and genetics. Electronic databases include the National Cancer Database (NCDB) and PubMed databases. Search words that are used are carcinogens, cancer, and genetics.

Inclusion and Exclusion Criteria

The inclusion criteria look at what the test requires for the review to be successful, while the exclusion criteria look at the features and things the study should not have or avoid during the research. The medical publications and journals on cancer used should be within the ten years of the study, so as to only have information that is the most relevant. There would be a meta-analysis of various scientific studies concerning genetics, cancer, and carcinogens. There is the use of big and informative case studies for the research. Outdated publications and journals are excluded. Small and irrelevant case studies are ignored because they would reduce the accuracy of the study.

Description of Evidence

The systematic review revealed six research studies on the relationship between cancer screening behaviors of people and family history. The research studies involved females from diverse areas to improve the accuracy of the study. The studies are cross-sectional in their nature. All of the studies were conducted on female adults. The studies were conducted between years of 1992 and 2013. The studies were all conducted within the duration, ranging from six months and six years. The sample size ranged from two hundred and sixteen participants to forty-seven thousands.

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Strength of Evidence

The quality of the study is strengthened by the diversity of participants. There were many female adults of different races, including Asians and Americans. There are different ages of participants which ensure that the results of the research studies are correct. The quality of the study is further evidenced by the scholarly publications of the research studies. The studies were conducted in different countries which increases the strength of the study, since a wider geographical region is reached.

There were thousands of female participants of the study that were a part of the studies of the association of cancer screening behavior and the family history. The studies were rated as positive, since the studies yielded the required results. The studies showed the association of cancer screening behavior and family history.

Location of the Studies

The studies were conducted in developed countries. The human development index defines the developed countries. One study was conducted in Japan, the other one was conducted in Britain, and four studies were conducted in the USA. When conducting the studies in different countries, it improves the accuracy of the results.


The studies were conducted on female participants who have an average of twenty to sixty-five years. The wide range of mean age increases the accuracy of the results, since the participants provide a wide range of data. Three studies have reported the race of the participants. One study reported its participants were Asian women from Japan. The other reported that its participants were all American women. The third study showed distributed races, ranging from Asian, American, Latina and Mexican nations.

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The other four studies did not reveal races of the participants. One study shows that there was a diverse selection of different ethnic backgrounds from the United States of America, Latin America, Europeans and Asians. Female participation in the studies of the association between cancer screening behaviors was at 100% since the review was only focused on the female gender.

The study uses female participants because studies show that more female people are more susceptible to getting breast and uterine cancer. The study participants had a family member who had or has any form of cancer. The study uses female participants who have the relatives or family members who have or had cancer to enable them to have an association between cancer screening and family history.


The participants in the study were shown various publications, verified the websites, and books that are related to carcinogens. The publications, verified websites, and books also have the information related to cancer and the way genetics influence cancer in human beings. The publications give examples on family history and cancer. The exposure is meant to bring out the association of cancer screening behavior and their specific family histories.

One cross-sectional study exposed its participants to medical publications and medical journals about cancer, so that they get the information on cancer carcinogens and causes of cancer. One study had its participants pass through free genetic counseling and testing program which exposes them to information on cancer, carcinogens, and the relation of genetics to cancer. One study looks at a meta-analytic review of previous mammography screenings and their influence on women (Isaacs et al., 2002).

The women look at the cancer screening sessions of previous patients as a motivation for cancer testing. The information they are exposed to be related to genetics and how it influences cancer. In another study, the participants in the study were involved in interviews with the researchers. The interviews involved an exchange of information about cancer. The interviews revealed to the women, the carcinogens and relationship between cancer and genetics. The interviews were carried out in order to determine the association between cancer screening behaviors and family history (Mccaul, Branstetter, Schroeder, & Glasgow, 1996).

All the studies used verified publications, web pages, multimedia sources that have information that has information on cancer. The verified information sources have the detailed information on carcinogens and relationships between genetics, the genetic makeup of a human being and types of cancer. Carcinogens are the causative agents that could trigger the growth of cancerous cells in person (Kash, Holland, Halper, & Miller, 1992).

Health Outcomes

The studies revealed that they had various health outcomes. The participants suffered from anxiety disorders from the time they learned about the possibility of getting cancer. Some participants develop insomnia and other sleeping disorders. The studies have caused the participants to get the irrational fears. The persistent anxiety increases muscle tension, which causes pain in the participants muscles. Muscle tension could also further lead to ligament damage in the knees or ankles (Kim et al., 2008).

Some participants got panic attacks characterized by breathing problems, nausea, dizziness and episodes of fainting. Other participants developed irritable bowel syndrome (IBS) due to the fear of getting cancer. Irritable bowel syndrome has the following symptoms:

1. Stomach aches

2. Cramping

3. Bloating

4. Constipation

5. Diarrhea.

Endpoint Outcomes

The end point outcomes refer to the final effects that happen to the various participants. The participants continuously increase in anxiety levels, causing them to increase the frequency of cancer screening to make sure they do not get the disease. Participants have developed anxiety disorder, panic attacks, insomnia, depression and irritable bowel syndrome (IBS) (Kash et al., 1992). The participants were encouraged to get guidance and counseling or therapy to alleviate the stress they were feeling from the cancer screening. Severe cases were given medication to relieve the participants from anxiety, insomnia, and irritable bowel syndrome (IBS) (Hailey, 1991).

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Intermediate Outcomes

The intermediate outcomes show the preview of the end outcome after the study is carried out. Intermediate outcomes of the study show that the patients had a slight increase in anxiety and sleeping problems. Some participants exhibited signs of incoming panic attacks. The participants had an increased heart rate and worried a lot.

Overview of the Evidence

Over 75% of people who have family members who have or had cancer are likely to get cancer as well (Matsubara, Hayashi, Sobue, Mizunuma, & Suzuki, 2013). It is important for people to have multiple cancer screening sessions to determine whether a person has contracted the disease. If the cancer is detected at an early stage, a person can be treated for it and avoid serious repercussions. People with the possibility of cancer avoid carcinogens and other health risks, such as smoking.

Future Research

Interest has grown to find the specific genetic marker that determines if someone can get cancer if his or her family has or had cancer. The genetic marker could be isolated to avoid increased cancer screening and the health outcomes, such as anxiety and insomnia.

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