A study in England demonstrated that, despite significant advances in science, medicine, and technology, socioeconomic status has a major impact on the acceptance of cancer screening. The study showed that even if health care is free, colorectal cancer screening rates among those without financial means are still low, and results of a new study suggest that may be due to an idea psychologists call cancer fatalism.
The belief that death is inevitable when cancer is present, has been identified as a barrier to participation in cancer screening, detection, and treatment.[2, 3] Anne Miles, Ph.D., a lecturer in psychology at Birbank, University of London, said those who felt that the cancer screenings wouldn?t help, or they were going to die of cancer anyway, often failed to comply with screening recommendations.
Her findings are published in a recent issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research. ?In England, the screenings are free and the subsequent health treatments are free as well, yet people of lower socioeconomic status still do not get screened. We wanted to find out what else was going on,? she said.
Miles and her colleagues analyzed data from 529 adults aged 60 to 69 who had completed a series of surveys measuring their socio-economic status, self-rated health and rate of cancer fatalism. These measures were tested against the rate of fecal occult blood testing. They found that men and women with higher socioeconomic status, better self-rated health and lower cancer fatalism were 56% more likely to undergo colorectal cancer screening by fecal occult blood testing.
Miles said cancer fatalism can be treated and managed if properly identified. ?There is clearly something else going on here besides costs. We need to understand peoples? attitudes toward screening,? said Miles. ?If they think it won?t help, they won?t do it, even if it?s free.?
For more information:
 Miles A, Rainbow S, Von Wagner C. Cancer Fatalism and Poor Self-Rated Health Mediate the Association between Socioeconomic Status and Uptake of Colorectal Cancer Screening in England. Cancer Epidemiol Biomarkers Prev October 2011 20; 2132. Published OnlineFirst September 27, 2011.
 Powe BD, Finnie R. Cancer fatalism: the state of the science. Cancer Nurs. 2003 Dec;26(6):454-65; quiz 466-7.
 Spurlock WR, Cullins LS.Cancer fatalism and breast cancer screening in African American women. ABNF J. 2006 Jan-Feb;17(1):38-43.