Abstract
Background:Cancer fear and fatalism are believed to be higher in ethnic minorities and may contribute to lower engagement with cancer prevention and early detection. We explored the levels of cancer fear and fatalism in six ethnic groups in the United Kingdom and examined the contribution of acculturation and general fatalism.Methods:A cross-sectional survey of 720 White British, Caribbean, African, Indian, Pakistani, and Bangladeshi women (120 of each) was conducted. Three items assessed cancer fear and two cancer fatalism. Acculturation was assessed using (self-reported) migration status, ability to speak English, and understanding of health leaflets; general fatalism with a standard measure.Results:Relative to White British women, African and Indian women were more fearful of cancer, Bangladeshi women less fearful, and Pakistani and Caribbean women were similar to White British women. Cancer fatalism was higher in all the ethnic minority groups compared with White British women. Less acculturated women were less likely to worry (ORs 0.21–0.45, all P<0.05) or feel particularly afraid (ORs 0.11–0.31, all P<0.05) but more likely to feel uncomfortable about cancer (ORs 1.97–3.03, all P<0.05). Lower acculturation (ORs 4.30–17.27, P<0.05) and general fatalism (OR 2.29, P<0.05) were associated with the belief that cancer is predetermined.Conclusions:In general, cancer fear and fatalism are more prevalent among ethnic minority than White British women and even more so in less acculturated ethnic minorities. This may affect their participation in cancer prevention and early detection.
Highlights
Cancer fear and fatalism are believed to be higher in ethnic minorities and may contribute to lower engagement with cancer prevention and early detection
Cancer fear and fatalism are associated with lower uptake of cancer screening (Straughan and Seow, 1998; Austin et al, 2002; Robb et al, 2008; Vrinten et al, 2015) and may contribute to delayed presentation of cancer symptoms (Robb et al, 2009; Beeken et al, 2011; Bergamo et al, 2013; Jones et al, 2014; Balasooriya-Smeekens et al, 2015; Lyratzopoulos et al, 2015)
It is increasingly recognised that fatalistic beliefs and emotional factors such as cancer fear need to be addressed in public health campaigns to successfully change behaviour (Niederdeppe and Levy, 2007; Robb et al, 2009)
Summary
A cross-sectional survey of 720 White British, Caribbean, African, Indian, Pakistani, and Bangladeshi women (120 of each) was conducted. Three items assessed cancer fear and two cancer fatalism. Acculturation was assessed using (self-reported) migration status, ability to speak English, and understanding of health leaflets; general fatalism with a standard measure. We commissioned them to recruit 120 women aged 30– 60 years from each of the following ethnic backgrounds: Indian, Pakistani, Bangladeshi, African, Caribbean, and White British, for a total sample size of 720 women. We opted for a commercial sampling service with extensive experience in recruiting respondents from ethnic minority backgrounds to make sure that recruitment into the study was not dependent on being registered with a GP and the GP contact details of potential participants being up-to-date and to reduce language and literacy barriers, which could have influenced recruitment rates
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