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Name
   
 
 
What is your ethnicity/race?
Parents were Born there You Were Born there Your Grandparents were Born there N/A
Central American
Mexican
South American
African American
Caucasian
Asian
 
 
 
Age
   
 
 
 
What is the number one cause of death of women in America?
 
Heart Disease
 
Stroke
 
Breast Cancer
 
 
 
Have you ever heard about breast cancer?
 
Yes
 
No
 
 
 
What do you think is the main causes of breast cancer?
 
Obesity
 
Not Having Kids
 
Family History
 
Blows and Bruises
 
Environmental Pollution
 
 
 
Who does breast cancer affect?
 
Men
 
Women
 
Both
 
 
 
Who gets breast cancer?
 
wealthy
 
poor
 
 
 
At what age do people get breast cancer?
 
0-17
 
18-30
 
31-39
 
40-45
 
50-65
 
65-75
 
80+

 
 
 
Is the breast cancer rate increasing or decreasing?
 
Yes
 
No