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. 2021 Sep;10(17):6048-6057.
doi: 10.1002/cam4.4122. Epub 2021 Jul 13.

The role of sex and rurality in cancer fatalistic beliefs and cancer screening utilization in Florida

Yi Guo  1   2 , Sarah M Szurek  1   2 , Jiang Bian  1   2 , Dejana Braithwaite  2   3   4 , Jonathan D Licht  2   5 , Elizabeth A Shenkman  1   2
Affiliations

The role of sex and rurality in cancer fatalistic beliefs and cancer screening utilization in Florida

Yi Guo et al. Cancer Med. 2021 Sep.

Abstract

Background: People's fatalistic beliefs about cancer can influence their cancer prevention behaviors. We examined the association between fatalistic beliefs and breast and colorectal cancer screening among residents of north-central Florida and tested whether there exists any sex or rural-non-rural disparities in the association.

Methods: We conducted a cross-sectional, random digit dialing telephone survey of 895 adults residing in north-central Florida in 2017. Using weighted logistic models, we examined the association between (1) respondents' sociodemographic characteristics and cancer fatalistic beliefs and (2) cancer fatalistic beliefs and cancer screening utilization among screening eligible populations. We tested a series of sex and rurality by fatalistic belief interactions.

Results: Controlling for sociodemographics, we found the agreement with "It seems like everything causes cancer" was associated with a higher likelihood of having a mammogram (odds ratio [OR]: 3.34; 95% confidence interval [CI]: 1.17-9.51), while the agreement with "Cancer is most often caused by a person's behavior or lifestyle" was associated with a higher likelihood of having a blood stool test (OR: 1.85; 95% CI: 1.12-3.05) or a sigmoidoscopy or colonoscopy among women (OR: 2.65; 95% CI: 1.09-6.44). We did not observe any rural-non-rural disparity in the association between fatalistic beliefs and cancer screening utilization.

Conclusions: Some, but not all, cancer fatalistic beliefs are associated with getting breast and colorectal cancer screening in north-central Florida. Our study highlights the need for more research to better understand the social and cultural factors associated with cancer screening utilization.

Keywords: colonoscopy; disparity; fecal occult blood test; mammography; sigmoidoscopy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Counties in the study area in north‐central Florida. The 19 counties in the catchment area of the large southeastern academic medical university
FIGURE 2
FIGURE 2
Weighted distributions of the cancer fatalistic beliefs. Number and weighted percentages of participants responding to each of the cancer fatalistic belief questions. Belief 1: It seems like everything causes cancer. Belief 2: There is not much you can do to lower your chances of getting cancer. Belief 3: There are so many different recommendations about preventing cancer, it is hard to know which ones to follow. Belief 4: When I think about cancer, I automatically think about death. Belief 5: Cancer is most often caused by a person's behavior or lifestyle
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