Cancer-Related Risk Perceptions and Beliefs in Texas: Findings from a 2018 Population-Level Survey

Abstract

Background: Cancer beliefs and perceptions of cancer risk affect the cancer continuum. Identifying underlying factors associated with these beliefs and perceptions in Texas can help inform and target prevention efforts.Methods: We developed a cancer-focused questionnaire and administered it online to a nonprobability sample of the Texas population. Weighted multivariable logistic regression analysis identified key factors associated with perceptions and beliefs about cancer.Results: The study population comprised 2,034 respondents (median age, 44.4 years) of diverse ethnicity: 45.5% were non-Hispanic white, 10.6% non-Hispanic black, and 35.7% Hispanic. Self-reported depression was significantly associated with cancer risk perceptions and cancer beliefs. Those indicating frequent and infrequent depression versus no depression were more likely to believe that: (i) compared to other people their age, they were more likely to get cancer in their lifetime [OR, 2.92; 95% confidence interval (CI), 1.95-4.39 and OR, 1.79; 95% CI, 1.17-2.74, respectively]; and (ii) when they think about cancer, they automatically think about death (OR, 2.05; 95% CI, 1.56-2.69 and OR, 1.46; 95% CI, 1.11-1.92, respectively). Frequent depression versus no depression was also associated with agreement that (i) it seems like everything causes cancer (OR, 1.67; 95% CI, 1.26-2.22) and (ii) there is not much one can do to lower one's chance of getting cancer (OR, 1.44; 95% CI, 1.09-1.89). Other predictors for perceived cancer risk and/or cancer beliefs were sex, age, ethnicity/race, being born in the United States, marital status, income, body mass index, and smoking.Conclusions: Depression and other predictors are associated with cancer risk perceptions and beliefs in Texas.Impact: Increased attention to reducing depression may improve cancer risk perceptions and beliefs.

Differences in Sun Protection Behaviors Between Rural and Urban Communities in Texas

“…The strengths and limitations of the overall survey have been discussed previously . Relevant to the current study, nonprobability sampling may have enriched for respondents with a particular interest in cancer prevention and thus behaviors may not reflect the general Texas population.…”

“…The overall study population included a nonprobability sample of 2,050 Texas residents including 50% females, 36.5% NHW, 25% NHB, 33.5% Hispanics, and 5% Asians/other (compared to Texas demographics, US Census, V2017: 50.3% females, 42% NHW, 12.7% NHB, 39.4% Hispanics, and 5% Asians) . Oversampling of NHBs was conducted to ensure more accurate estimates for this minority group.…”

“…The Texas health screening survey was composed of 153 measures with the majority of questions derived from the National Health Interview Survey (NHIS), Health Information National Trends Survey (HINTS), and Behavioral Risk Factor Surveillance System Questionnaire, as detailed elsewhere . The instrument was prepared in both English and Mexican Spanish using the services of Masterword Services, Inc. (Houston, Texas), and administered through the Qualtrics online survey platform (Qualtrics International Inc., Provo, Utah and Seattle, Washington).…”

“…The analytical data set included 2,034 respondents . In order to calibrate the study sample to the state's demographics, data were weighted by ICF International, Inc. (Fairfax, Virginia) using a 3‐dimensional raking approach with iterative poststratification based on: sex; 3‐category age (18‐44, 45‐59, and 60 and over); and 4‐category race/ethnicity (NHW, NHB, Hispanic, and other) .…”

“…We hypothesized that sun protection behaviors and sunburn prevalence would differ amongst Texas residents living in rural and urban communities. To test this hypothesis, we analyzed data from a 2018 statewide Texas health screening survey that included assessment of cancer prevention behaviors in a nonprobability sample of the Texas population to reveal key differences in sunscreen use and sunburn history . Our results should help target future intervention strategies for reduction of skin cancer prevalence across the state.…”