Information About You

In order to help us evaluate the cancer prevention education program we would like you to provide the following information about you. Your personal information will not be shared with anyone. Your responses to this survey are completely confidential.

 

Are you a cancer patient or survivor from an El Camino Health hospital?
Select your gender:
Select the group that reflects your age:
Select your race/ethnicity

Survey

Identify one personal lifestyle practice that is associated with an increased risk for developing breast cancer.
Select at least two changes in health practices that decrease the risk of developing breast cancer.
Identify one way that you could get information about prevention of breast cancer.
Have you had any of these symptoms of breast cancer?

(Select all that apply)

Have you performed a breast self-exam before?
If not, why have you not performed a breast self-exam before?
Does a doctor or other medical provider routinely check your breasts for abnormalities?
If no, why have you not had a doctor or other medical provider check your breasts for abnormalities?
Have you had a mammogram before?
If no, why have you not had a mammogram before?
Which of these other tests for breast cancer have you heard of?

(Select all that apply)

Which of these treatments for breast cancer have you heard of?

(Select all that apply)

Do you think that breast cancer is preventable?
By which of the following methods do you think it can be prevented?
Should women get a mammogram every year between the ages of 45 to 54?
Can women that are 55 years or older switch to mammograms every two years instead of yearly?
Is a screening MRI important for women that are at high risk for breast cancer?
What risk factors for breast cancer in men include?

 

References:

www.cdc.gov/cancer/breast/basic_info/index.htm
www.cancer.org/content/dam/cancer-org/cancer-control/en/booklets-flyers/breast-cancer-fact-sheet.pdf
www.elcaminohealth.org/library/breast-cancer-symptoms
www.elcaminohealth.org/services/cancer-care/conditions-treatments/breast-cancer
www.elcaminohealth.org/library/about-breast-cancer-men

 


El Camino Health includes two not-for-profit acute care hospitals in Los Gatos and Mountain View, including urgent care, multi-specialty care and primary care locations across Santa Clara County.

Learn more at elcaminohealth.org