Table 4.

Perceptions of modality-specific regimen, possible side effects, and effectiveness

Modality-specific factors of willingness to use chemopreventive agents
ModalityPerceptions of regimenPerceptions of side effectsPerceptions of effectiveness
Pill (for breast/ovarian cancers)
  • - Noted ease and convenience of being able to fit into and/or combine with existing daily routines (e.g., brushing teeth, taking birth control pill)

  • - Expressed uncertainty in their ability to carry out a daily pill regimen for 5 years

  • - Concerned about impact of missing a dose

  • - Expressed most concern for increased risk of uterine cancer and blood clots – perceived as too serious for preventive purposes

  • - Considered pills not as effective as modalities that delivered medicine directly to the organ(s) of concern

  • - Perceived risk-reduction activities, such as diet and exercise, to be more effective

Topical agent – gel/cream (for all cancers)
  • - Perceived as easy and convenient

  • - Expressed confidence in being able to fit it into their existing daily routines (e.g., beauty/skin care regimen) indefinitely

  • - Preferred regimen that did not require application outside the home

  • - Wanted to know more about the application process, such as whether they could take a shower after applying or if reapplication would be necessary after exercise or sweating

  • - Concerned about the severity and duration of the irritated skin and rash

  • - Worried about an unpleasant application process or impact on their skin (e.g., messy application process, leaves a sticky residue, dries out their skin, skin smells during/after application, stains clothing)

  • - Noted that sensitivity to light was not a problem as long as they could still enjoy activities outside

  • - Concerned for others that may come in contact with topical agent (e.g., intimate encounters with partner, child sleeping on their chest)

  • - Skeptical of how a gel/cream could be effective at preventing cancer without serious side effects, such as interfering with hormones

Topical agent – mouthwash (for head/neck/oral cancers)
  • - Perceived as simple and convenient

  • - Cited ease in being able to fit into and/or combine with existing daily routines (e.g., brushing teeth)

  • - Expressed confidence in being able to adhere to regimen indefinitely

  • - Felt that swishing and/or rinsing was less invasive than swallowing

  • - Worried about how the rash would impact their ability to breathe, communicate, and eat

  • - Apprehensive about taste (e.g., leaves a bad taste in mouth, gag reflex effect)

  • - Concerned about the severity and duration of the irritated skin or rash, and if it would have a “domino effect” leading to sores or blisters, and possibly infections

  • - Skeptical of how a mouthwash could be effective at preventing cancer

Hormonal implant or ring (for gynecologic cancers)
  • - Unwillingness stemmed from negative experiences with birth control (e.g., intrauterine device, vaginal ring)

  • - Concerned about invasive nature of the modality, citing their fear of having a foreign object inside their body

  • - Expressed comfort in having a doctor involved to properly insert the device

  • - Apprehensive about taking the power and/or control out of their hands

  • - Concerned about increasing side effects already experienced through menstruation, birth control, or other gynecologic conditions (e.g., PCOS)

  • - Disliked the possibility of weight gain

  • - Alarmed about the possibility of ovarian cysts and hormones' impact on fertility, pregnancy, and breastfeeding

  • - Considered more effective because a healthcare provider inserts the device

Aerosolized drug (for lung cancer)
  • - Felt comfortable using due to prior experience and/or familiarity with an inhaler (e.g., asthma, allergies)

  • - Noted the convenience factor of being able to carry it with you

  • - Hesitant (more so average-risk participants) to carry small aerosolized drug device

  • - Preferred frequency of use varied greatly

  • - High-risk participants expressed willingness to increase frequency of use for a shorter duration of time (e.g., daily use for 30 days) or indefinite use

  • - Perceived to have fewer side effects (compared to a pill)

  • - Concerned about severity and duration of cough (e.g., impact on sleeping, interference at work)

  • - Some high-risk participants familiar with coughing due to smoking and COPD were worried about increased coughing

  • - Other participants were unconcerned and considered it mild in the context of cancer

  • - Considered more effective due to local delivery and minimal impact on other organ systems

Light stimulation therapy (for head/neck/oral cancers)
  • - Liked the convenience of a one-time treatment

  • - Concerned about accessibility to a clinic

  • - Expressed comfort in knowing a healthcare provider would be involved

  • - Unconcerned about need to take a pill along with the light therapy

  • - Wanted to know more about the regimen (e.g., length of session) and type of light being used

  • - Concerned about “long laundry list” of possible side effects

  • - Alarmed about possible burning and/or scarring (especially to their face)

  • - Frightened by shortness of breath and trouble swallowing

  • - Some interpreted side effects to be specific to their eyes (e.g., burning, irritation, itching) and worried about eyesight

  • - Worried about light sensitivity impacting their ability to be outdoors

  • - Found side effects to be similar to cancer treatment

  • - Wanted to see tangible evidence of effectiveness

Prophylactic surgery
  • - Viewed as a “last resort”

  • - Needed to be at high risk in order to consider

  • - Concerned about surgical complications and recovery time

  • - Expressed hesitation (especially 30–45 year olds) due to desire to have children and breastfeed

  • - Worried about impact on hormones and sexual pleasure

  • - Noted emotional impact of a mastectomy, but found benefit in being able to consider reconstructive surgery

  • - Expected significant reduction and/or elimination of cancer

  • Abbreviations: COPD, chronic obstructive pulmonary disease; PCOS, polycystic ovary syndrome.