Cancer Fatalism: Deterring Early Presentation and Increasing Social Inequalities?
Cancer Fatalism: Deterring Early Presentation and Increasing Social Inequalities?
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DOI：
10.1158/1055-9965.epi-11-0437
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发表时间：
2011-10-01
影响因子：
3.8
通讯作者：
Wardle, Jane
中科院分区：
文献类型：
--
作者：
Beeken, Rebecca J.;Simon, Alice E.;Wardle, Jane
背景：关于癌症的宿命论信念与筛查率低和就诊延迟有关，特别是在低社会经济地位（SES）群体中，但没有研究系统评估SES、宿命论和早期检测行为之间的相互关系。我们探讨了（i）宿命论是否与对早期发现的消极态度相关，（ii）较低社会经济地位群体更加宿命论，以及（iii）宿命论中的社会经济地位差异部分解释了社会经济地位对早期发现态度的差异。方法：在英国成年人的人口代表性样本中，在家庭环境中使用基于计算机的访谈，受访者（N = 2,018）回答了两个索引宿命论的问题（对癌症生存和治愈的期望）和两个关于早期发现态度的项目（感知到的早期发现态度）。早期发现的价值和对症状报告的恐惧）。 SES 以社会等级分类为索引。结果：宿命论与早期检测不太积极相关（β = -0.40，P < 0.001），并且更害怕因可疑症状寻求帮助（β = 0.24，P < 0.001）。社会经济地位较低的群体更加宿命论（β = -0.21，P < 0.001）。路径分析表明，宿命论中的 SES 差异可能解释了对早期检测的态度上的 SES 差异。结论：在该人群样本中，宿命论中的 SES 差异部分解释了早期检测感知价值和对症状表现的恐惧方面的 SES 差异。影响：关于癌症的宿命论信念应以促进癌症的早期表现为目标，这对于较低 SES 群体可能尤其重要。癌症流行病学生物标志物20(10)； 2127-31。 (C)2011 AACR。
Background: Fatalistic beliefs about cancer have been implicated in low uptake of screening and delay in presentation particularly in low socioeconomic status (SES) groups, but no studies have systematically evaluated interrelationships between SES, fatalism, and early detection behaviors. We explored whether (i) fatalism is associated with negative attitudes toward early detection, (ii) lower SES groups are more fatalistic, and (iii) SES differences in fatalism partly explain SES differences in attitudes toward early detection.Methods: In a population-representative sample of adults in Britain using computer-based interviews in the home setting, respondents (N = 2,018) 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: Fatalism was associated with being less positive about early detection (beta = -0.40, P < 0.001) and more fearful about seeking help for a suspicious symptom (beta = 0.24, P < 0.001). Lower SES groups were more fatalistic (beta = -0.21, P < 0.001). Path analyses suggest that SES differences in fatalism might explain SES differences in attitudes about early detection.Conclusions: In this population sample, SES differences in fatalism partly explained SES differences in the perceived value of early detection and fear of symptom presentation.Impact: Fatalistic beliefs about cancer should be targeted to promote early presentation of cancer and this may be particularly important for lower SES groups. Cancer Epidemiol Biomarkers Prev; 20(10); 2127-31. (C)2011 AACR.