Elizabeth A Sarma1,2, Samantha L Quaife3, Katharine A Rendle4, Sarah C Kobrin1. 1. Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA. 2. Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland, USA. 3. Department of Behavioral Science and Health, University College London, London, England. 4. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Abstract
OBJECTIVE: Socioeconomic gaps in cancer mortality may be driven partially by poorer uptake of early detection behaviors among lower socioeconomic status (SES) groups. Lower SES groups may hold both fewer positive and more negative cancer beliefs that discourage these behaviors. We examined SES differences in positive and negative cancer beliefs in US adults. METHODS: We conducted telephone interviews with a population-representative sample, aged 50+, using the Awareness and Beliefs about Cancer instrument (N = 1425). Cancer beliefs were measured using three positively and three negatively framed items. We used multivariable logistic regression models to examine associations between beliefs and education, which served as a marker of individual-level SES. RESULTS: Agreement with positive statements was high (>80%) and did not vary with education, while agreement with negative statements varied. Relative to adults with a bachelor's degree, adults with a high school degree or less were more likely to agree that "treatment is worse than cancer" (45.2% vs. 68.2%; adjusted odds ratio (aOR) = 2.43, 99% CI = 1.50-3.94), cancer is "a death sentence" (17.4% vs. 33.2%; aOR = 2.51, 99% CI = 1.45-4.37), and they "would not want to know if I have cancer" (15.7% vs. 31.6%; aOR = 2.88, 99% CI = 1.54-5.36). CONCLUSIONS: Positive cancer statements were generally endorsed, but negative statements were more frequently endorsed by lower SES groups. Additional work is needed to understand how negative beliefs develop and coexist alongside positive beliefs. Interventions to improve detection behaviors targeting lower SES groups may benefit from focusing on reducing negative beliefs, rather than increasing positive beliefs.
OBJECTIVE: Socioeconomic gaps in cancer mortality may be driven partially by poorer uptake of early detection behaviors among lower socioeconomic status (SES) groups. Lower SES groups may hold both fewer positive and more negative cancer beliefs that discourage these behaviors. We examined SES differences in positive and negative cancer beliefs in US adults. METHODS: We conducted telephone interviews with a population-representative sample, aged 50+, using the Awareness and Beliefs about Cancer instrument (N = 1425). Cancer beliefs were measured using three positively and three negatively framed items. We used multivariable logistic regression models to examine associations between beliefs and education, which served as a marker of individual-level SES. RESULTS: Agreement with positive statements was high (>80%) and did not vary with education, while agreement with negative statements varied. Relative to adults with a bachelor's degree, adults with a high school degree or less were more likely to agree that "treatment is worse than cancer" (45.2% vs. 68.2%; adjusted odds ratio (aOR) = 2.43, 99% CI = 1.50-3.94), cancer is "a death sentence" (17.4% vs. 33.2%; aOR = 2.51, 99% CI = 1.45-4.37), and they "would not want to know if I have cancer" (15.7% vs. 31.6%; aOR = 2.88, 99% CI = 1.54-5.36). CONCLUSIONS: Positive cancer statements were generally endorsed, but negative statements were more frequently endorsed by lower SES groups. Additional work is needed to understand how negative beliefs develop and coexist alongside positive beliefs. Interventions to improve detection behaviors targeting lower SES groups may benefit from focusing on reducing negative beliefs, rather than increasing positive beliefs.
Authors: Robin C Vanderpool; Bin Huang; Yangyang Deng; Todd M Bear; Quan Chen; Meghan F Johnson; Electra D Paskett; Linda B Robertson; Gregory S Young; Ronaldo Iachan Journal: J Rural Health Date: 2019-03-04 Impact factor: 4.333
Authors: Marc A Kowalkowski; Stacey L Hart; Xianglin L Du; Sarah Baraniuk; David M Latini Journal: J Cancer Surviv Date: 2012-03-29 Impact factor: 4.442
Authors: Sonia A Cunningham; Robert Yu; Tina Shih; Sharon Giordano; Lorna H McNeill; Ruth Rechis; Susan K Peterson; Paul Cinciripini; Lewis Foxhall; Ernest Hawk; Sanjay Shete Journal: Cancer Epidemiol Biomarkers Prev Date: 2019-01-30 Impact factor: 4.254
Authors: Tim E Byers; Holly J Wolf; Katrina R Bauer; Susan Bolick-Aldrich; Vivien W Chen; Jack L Finch; John P Fulton; Maria J Schymura; Tiefu Shen; Scott Van Heest; Xiang Yin Journal: Cancer Date: 2008-08-01 Impact factor: 6.860
Authors: Georgios Lyratzopoulos; Michael Pang-Hsiang Liu; Gary A Abel; Jane Wardle; Nancy L Keating Journal: Cancer Epidemiol Biomarkers Prev Date: 2015-02-03 Impact factor: 4.254
Authors: Jocelyn V Wainwright; Shivan J Mehta; Alicia Clifton; Claire Bocage; Shannon N Ogden; Sarah Cohen; Katharine A Rendle Journal: Am J Health Promot Date: 2021-12-31
Authors: Dylan Graetz; Silvia Rivas; Lucia Fuentes; Ana Cáceres-Serrano; Gia Ferrara; Federico Antillon-Klussmann; Monika Metzger; Carlos Rodriguez-Galindo; Jennifer W Mack Journal: BMJ Glob Health Date: 2021-05