Cancer‐Related Beliefs and Perceptions in Appalachia: Findings from 3 States

Abstract

Background:Appalachians experience increased rates of cancer incidence and mortality compared to non-Appalachians. Many factors may contribute to the elevated cancer burden, including lack of knowledge and negative beliefs about the disease. Methods: Three National Cancer Institute (NCI)-designated cancer centers with Appalachian counties in their respective population-based geographic service areas-Kentucky, Ohio, and Pennsylvania-surveyed their communities to better understand their health profiles, including 5 items assessing cancer beliefs. Weighted univariate and bivariate statistics were calculated for each of the 3 state's Appalachian population and for a combined Appalachian sample. Weighted multiple linear regression was used to identify factors associated with a cancer beliefs composite score. Data from the combined Appalachian sample were compared to NCI's Health Information National Trends Survey (HINTS). Results: Data from 1,891 Appalachian respondents were included in the analysis (Kentucky = 798, Ohio = 112, Pennsylvania = 981). Significant differences were observed across the 3 Appalachian populations related to income, education, marital status, rurality, perceptions of present income, and body mass index (BMI). Four of 5 cancer beliefs were significantly different across the 3 states. Education, BMI, perceptions of financial security, and Kentucky residence were significantly associated with a lower composite score of cancer beliefs. When comparing the combined Appalachian population to HINTS, 3 of 5 cancer belief measures were significantly different. Conclusions: Variations in cancer beliefs were observed across the 3 states' Appalachian populations. Interventions should be tailored to specific communities to improve cancer knowledge and beliefs and, ultimately, prevention and screening behaviors.

Negative cancer beliefs: Socioeconomic differences from the awareness and beliefs about cancer survey

“…Similar to previous studies from the United States, which have relied on items from HINTS, we also found SES differences in negative cancer beliefs 11,16,23–26 . Though HINTS is also a population‐based survey of US adults, the cancer belief items are distinct, and the results for similar items provide different conclusions.…”

“…To our knowledge, previous US studies examining SES differences in cancer beliefs have, to date, examined negative beliefs, and relied on items from the Health Information National Trends Survey (HINTS), which focuses on beliefs about cancer prevention 11,16,23–26 . It is therefore unknown whether the results from the United Kingdom and Denmark are applicable to the United States, which has a different healthcare system and different recommendations for early detection and access to health care.…”

Spatial patterns in prostate Cancer-specific mortality in Pennsylvania using Pennsylvania Cancer registry data, 2004–2014

“…One possible reason is racial disparity regarding cancer treatment in PA, which could impact quality of healthcare and physician-patient communications [11,12]. Other contributing factors include limited access to healthcare and PC screening, low socioeconomic status, environmental or occupational exposure to heavy metals, participation in unhealthy lifestyle behaviors (i.e., cigarette smoking and lack of physical activity), and variation in cancer beliefs and perceptions [13][14][15][16]. Therefore, it is recognized that analyzing PCspecific mortality is a multifactorial process that involves the assessment of interactions amongst patients, providers and healthcare facilities, and their communities.…”

Factors associated with not receiving HPV vaccine among adolescents by metropolitan statistical area status, United States, National Immunization Survey–Teen, 2016–2017

“…12 Finally, fatalistic beliefs about cancer prevention efforts among rural residents and its negative impact on HPV vaccination have also been cited as contributing factors. [13][14][15] There are limited data examining differences in HPV vaccination coverage by MSA status, particularly among adolescents not initiating the HPV vaccine series. A 2014 analysis noted lower coverage for ≥1 dose of HPV vaccine among adolescents living in other areas when compared to those living in mostly urban areas.…”