Cancer Health_Fall_2021

Cancer in Women
It’s estimated that one in three women will receive a cancer diagnosis during her lifetime. Making healthy choices can reduce your risk for the disease, and regular screenings can help detect cancer early, when it may be easier to treat. Let us know how you protect yourself from cancer.
Do you do a breast self-exam every month?

YesNo
Have you ever had a mammogram?

YesNo
Have you ever had a colonoscopy?

YesNo
Have you ever been screened for lung cancer?

YesNo
Have you ever been screened for cervical cancer?

YesNo
Have you ever been screened for skin cancer?

YesNo
Have you been diagnosed with cancer? If so, what kind(s)? (Check all that apply.)

BreastCervicalColorectalEndometrialLungOvarianSkinI have not been diagnosed with cancer.Other
Do you limit your exposure to UV rays from the sun and other sources?

YesNo
Do you have obesity or overweight?

YesNo
Do you drink alcohol?

YesNo
Do you currently smoke cigarettes, or are you a former smoker?

YesNo
Do you have a family history of breast, ovarian or uterine cancer?

YesNo
Have you ever had any of these symptoms for longer than two weeks? (Check all that apply.)

BloatingBlood in the stoolChanges to the breast or nippleChronic coughingLoss of appetitePersistent constipationSkin changesStomach pain or nauseaUnexplained bruisesUnexplained weight lossUnusual bleeding
What year were you born?
What is your gender?

MaleFemaleTransgenderOther
What is your current level of education?

Some high schoolHigh school graduateSome collegeBachelor's degree or higherGraduate or professional degree
What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
What is your ZIP code?
Enter the message as it's shown*
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Cancer in Women