ASPO Abstracts

Negative cancer beliefs: Socioeconomic differences from the Awareness and Beliefs about Cancer Survey

Authors: Sarma EA, Quaife SL, Rendle KA, Kobrin SC

Category: Behavioral Science & Health Communication
Conference Year: 2020

Abstract Body:
Purpose: Socioeconomic gaps in cancer mortality are widening and 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 uptake of these behaviors. Given persistent cancer disparities by SES, this study examined differences in positive and negative beliefs about cancer by SES among adults in the United States (US). Methods: Telephone interviews with a population-representative sample, aged 50 years or older, were conducted in the US using an adapted Awareness and Beliefs about Cancer (ABC) instrument (N=1,425). Cancer beliefs were measured by three positively and three negatively framed items (e.g., “cancer can often be cured,” “most cancer treatment is worse than the cancer itself”). SES was indexed by educational attainment (bachelor’s degree and above, some college, high school or lower). Multivariable logistic regression models, adjusted for age, gender, marital status, race, self-rated health, and cancer experience, were used to examine associations of SES with cancer beliefs. Results: Agreement with positive statements about cancer was high (>80%) and did not vary with education. In contrast, agreement with negative statements varied with education. 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 the cancer itself” (45.2% vs. 68.2%; aOR=2.43, 95% CI=1.68-3.51), cancer is “a death sentence” (17.4% vs. 33.2%; aOR=2.51, 95% CI=1.65-3.83), and they “would not want to know if I have cancer” (15.7% vs. 31.6%; aOR=2.88, 95% CI=1.79-4.62). Conclusions: Lower SES groups held more negative cancer beliefs but often in co-existence with positive beliefs about cancer, which were frequently endorsed regardless of SES. Additional work is needed to better understand how lower SES groups develop these negative cancer beliefs, whether they persist over time, and how they might co-exist alongside positive cancer beliefs. In turn, interventions to improve cancer detection behaviors targeting lower SES groups may be more successful if they focus on reducing negative beliefs rather than increasing positive beliefs.

Keywords: beliefs, socioeconomic status, inequality