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Cancer Services

Cancer Risk Appraisal Determine your risk with this simple self-evaluation Cancer is not a disease that randomly chooses its victims. In fact, there are many things you can do to prevent cancer – or at the very least, discover it early to increase your chance of survival. The first step is to know what puts you at risk and then reduce those risks. Answer the following questions about your risk factors. There are no “right” or “wrong” replies. 1. Have n l s

you ever smoked? No Yes, but I have quit Yes, I am currently a smoker

9. Have you ever been diagnosed with inflammatory bowel disease? n No l Yes

2. If you have quit, how many years ago did you stop smoking? n More than 15 l 5-15 s Less than 5 3. Do you smoke or have you ever smoked a pipe or cigars? n No l Yes 4. Have you ever noticed white or red patches inside your mouth? n No l Yes 5. Do you or have you ever chewed tobacco or used smokeless tobacco regularly? n No l Yes

FOR MEN ONLY 10. If you had an undescended testicle at birth, was it corrected or removed through surgery? n Yes, it was removed l Yes, it was corrected s No, it is still undescended 11. Do you regularly eat high-fat foods? n No l Yes 12. Are you African-American, 60 years or older? n No l Yes FOR WOMEN ONLY 13. Has anyone in your family had breast cancer before reaching menopause? (Family includes mother, grandmother, sister or daughter.) n No l Yes

6. Do you regularly drink three or more alcoholic beverages a day (beer, wine or liquor)? n No l Yes

14. If yes, did the breast cancer affect both breasts? n No l Yes

7. Have your ever been told you have polyps (small growths) in the colon? n No l Yes

15. Do any of the following statements apply to you? n I am younger than 30 and have no children l I am 30 years old and have no children s I had my first child when I was 30 or older

8. Has anyone in your family ever had polyps or bowel cancer? n No l Yes

16. How old were you when you began your menstrual periods? n Age 13 or older l Age 12 or younger

1350 Walton Way | Augusta, GA 30901 706/828-2522 or toll free 866/869-2522

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17. In which of these age groups do you belong? n I am younger than 55 l I am 55 or older s I am 55 or older and still menstruating

20. If you have multiple sex partners, do you use barrier contraception, such as a condom or diaphragm? n I do not have multiple sex partners l Yes s No

18. Are you overweight (20 percent above your ideal weight), diabetic or do you have high blood pressure? n No l Yes 19. Have you ever taken female hormone therapy (estrogen) for post-menopausal symptoms for longer than six months? n No l Yes

LEGEND n Average risk l Increased risk s Elevated risk

Score each question using the legend above as your guide.

About Your Answers If your answers to these questions show you to be at higher than average risk, you should think about things you can do to help take control of your risks. Take the offensive. If you have a family history of a specific cancer, talk to your physician about it and make sure you pursue regular screenings. A good rule of thumb is to begin screenings 10 years before the age your closest relative was diagnosed with cancer. To learn more about reducing your risk or to find a physician who practices at University Hospital, call University’s Cancer Answer Line at 706/828-2522 or toll free at 866/869-2522.

8110.6774.1/Sept. 2007 [271905]


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