Even if health care is free, colorectal cancer screening rates among those without financial means are still low, and results of a new study suggest that may be due to an idea psychologists call cancer fatalism.
Anne Miles, Ph.D., a lecturer in psychology at Birkbeck, University of London, said those who felt that the cancer screenings wouldn't help, or they were going to die of cancer anyway, often failed to comply with screening recommendations.
Her findings are published in a recent issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
"In England, the screenings are free and the subsequent health treatments are free as well, yet people of lower socioeconomic status still do not get screened. We wanted to find out what else was going on," she said.
Miles and her colleagues analyzed data from 529 adults aged 60 to 69 who had completed a series of surveys measuring their socioeconomic status, self-rated health and rate of cancer fatalism. These measures were tested against the rate of fecal occult blood testing.
They found that men and women with higher socioeconomic status, better self-rated health and lower cancer fatalism were 56 percent more likely to undergo colorectal cancer screening by fecal occult blood testing.
Miles said cancer fatalism can be reduced if properly identified.
"There is clearly something else going on here besides costs. We need to understand peoples' attitudes toward screening," said Miles. "If they think it won't help, they won't do it, even if it's free."
- Anne Miles, Sandra Rainbow, Christian von Wagner. Cancer Fatalism and Poor Self-Rated Health Mediate the Association between Socioeconomic Status and Uptake of Colorectal Cancer Screening in England. Cancer Epidemiology, Biomarkers & Prevention, 2011; DOI: 10.1158/1055-9965.EPI-11-0453
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