Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.
Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.
J Behav Med. 2022 Dec;45(6):954-961. doi: 10.1007/s10865-022-00358-7. Epub 2022 Sep 9.
Cancer fatalism-the belief that death is inevitable when cancer is present-has been identified as a barrier to cancer screening, detection, and treatment. Our study examined the relationship between self-reported cancer fatalism and adherence to cancer screening guidelines of the breasts, cervix, colon, and prostate among a diverse sample of urban-dwelling adults in Brooklyn, New York. Between May 2019 and August 2020, we conducted a cross-sectional survey of adults 40 + years of age (n = 2,341) residing in Brooklyn neighborhoods with high cancer mortality. Multivariable logistic regression models were used to assess the odds of reporting cancer screening completion across three fatalistic cancer belief categories (low, med, high). Participants' median age was 61 (IQR 51, 71) years, 61% were women, 49% self-identified as non-Hispanic black, 11% Hispanic, 4% Asian, and 6% more than one race. There were no statistically significant differences in the proportion of low, some, or high fatalistic beliefs identified among male respondents compared to women. Among women, we observed that high fatalistic cancer beliefs were associated with higher odds (OR 2.01; 95% CI 1.10-3.65) of completing breast but not cervical (1.04; CI 0.55-1.99) or colon (1.54; CI 0.88-2.69) cancer screening. Men with high fatalistic cancer beliefs had a trend towards lower odds of prostate screening (OR 0.53: 95% CI 0.18-1.57) compared to men with low fatalistic beliefs, but neither was statistically significant. Findings suggest that high fatalistic cancer beliefs may be an important factor in cancer screening utilization among women. Further examination in longitudinal cohorts with a larger sample of men may be needed in order to identify any significant effect.
癌症宿命论——即认为癌症存在时死亡是不可避免的——已被确定为癌症筛查、检测和治疗的障碍。我们的研究检查了自我报告的癌症宿命论与在纽约布鲁克林市居住的不同族裔的成年人中乳房、子宫颈、结肠和前列腺癌症筛查指南的坚持之间的关系。在 2019 年 5 月至 2020 年 8 月期间，我们对居住在布鲁克林高癌症死亡率社区的 40 岁及以上成年人（n=2341）进行了横断面调查。多变量逻辑回归模型用于评估在三个癌症宿命论信念类别（低、中、高）中报告癌症筛查完成情况的可能性。参与者的中位年龄为 61 岁（IQR 51,71），61%为女性，49%自认为是非西班牙裔黑人，11%为西班牙裔，4%为亚裔，6%为多种族裔。在男性受访者中，低、中或高宿命论信念的比例与女性相比没有统计学上的显著差异。在女性中，我们观察到，高宿命论癌症信念与更高的乳腺癌筛查完成几率（OR 2.01；95%CI 1.10-3.65）相关，但与子宫颈癌（1.04；CI 0.55-1.99）或结肠癌（1.54；CI 0.88-2.69）筛查无关。与低宿命论信念的男性相比，高宿命论癌症信念的男性进行前列腺筛查的几率呈下降趋势（OR 0.53：95%CI 0.18-1.57），但均无统计学意义。研究结果表明，高宿命论癌症信念可能是女性癌症筛查利用的一个重要因素。可能需要在具有更大男性样本的纵向队列中进行进一步检查，以确定是否存在任何显著影响。
