Colon cancer: Fatalism linked to lower screening rates

In England, getting screened and treated for colorectal cancer -- the second leading cause of cancer death in the United Kingdom and worldwide -- is free. So why do only about half of thepopulation go through with it?

The answer, suggests a new study in the journal Cancer Epidemiology, Biomarkers and Prevention, is something of a self-fulfilling prophecy:people believe if they’re going to get cancer, they’ll die from it anyway, so why bother?

This attitude, known as cancer fatalism, is known to be a factor in African Americans’ lower rates of colorectal cancer screening in the U.S. It may also be a key reason people of lower socioeconomic status in the U.K. fail to follow through on testing, reported University of London Psychologist Anne Miles and colleagues.

Miles and her team looked at mail questionnaires on attitudes toward health and cancer worry that had been filled out by 529 adults, age 60 to 69, in the London area between August 2005 and January 2006. With the permission of the respondents and their doctors, the researchers then checked with the London Bowel Cancer Screening Hub to see which of the people had taken part in a national colon cancer screening program that provided a fecal occult blood test, which measures blood in the stool, which can be an indication of polyps or cancer in the bowels.

Fifty-six percent of the respondents got the test. As seen in the past, people in higher socioeconomic groups were more likely to follow through than less wealthy people. But the health attitudes survey gave a clue why: It showed that people who thought they were less healthy were more fatalistic about cancer and had lower screening rates.

“There are beliefs about cancer that could be addressed in the years before a screening invitation that may enhance uptake among people with lower socioeconomic status,” the coauthors wrote.

The abstract of the Cancer Epidemiology, Biomarkers and Prevention study is available here.