Cancer fatalism: deterring early presentation and increasing social inequalities?


Year:

Session type:

Rebecca Beeken1, Alice Simon1, Christian von Wagner1, Katriina Whitaker1, Jane Wardle1
1University College London, London, UK

Background

Fatalistic beliefs about cancer have been implicated in low uptake of screening and delay in presentation, but no studies have systematically evaluated inter-relationships between SES, fatalism, and early detection behaviours. We hypothesised that i) fatalism would be associated with negative attitudes towards early detection, ii) lower SES groups would be more fatalistic, and iii) SES differences in fatalism would partly explain SES differences in attitudes about early detection.

Method

In a population-representative sample of adults in Britain using computer-based interviews in the home setting, respondents (N=2018) answered two questions to index fatalism (expectations of cancer survival and cure) and two items on early detection attitudes (the perceived value of early detection and fear of symptom reporting). SES was indexed with a social grade classification.

Results

As predicted, fatalism was associated with being less positive about early detection (b=-0.40, p<.001) and more fearful about seeking help for a suspicious symptom (b=0.24, p<.001). Lower SES groups were more fatalistic (b=-0.21, p<.001).  Path analyses supported the suggestion that SES differences in fatalism might explain SES differences in attitudes about early detection.

Conclusion

In this population sample, SES differences in fatalism partly explained SES differences in the perceived value of early detection and fear of symptom presentation. Fatalistic beliefs about cancer should be targeted in order to promote early presentation of cancer and this may be particularly important for lower SES groups.