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‘Health Chatter’: Research Department of Behavioural Science and Health Blog



Ethnic minority women more fatalistic about cancer

By Charlotte Vrinten, on 2 March 2016

This blog was originally posted on the BioMed Central blogs network.

Cancer fear and fatalism may cost people their lives if it causes them to avoid cancer screening or seeing their doctor with symptoms.  A new study from the Health Behaviour Research Centre, published today in the British Journal of Cancer, shows that cancer fear and fatalism may be more prevalent among ethnic minority groups, which could help explain their lower engagement with early detection of cancer.

Earlier studies from the HBRC have looked at different aspects of cancer fear and how they affect willingness to attend cancer screening [1,2].  For example, in a study about colorectal cancer screening, we showed that worrying about cancer increased intention to be screened, but feeling uncomfortable at the thought of cancer made people less likely to attend screening [1].

In a different analysis of the same sample, we showed that those from an ethnic minority background were more likely to worry about cancer and feel uncomfortable thinking about cancer [3].  However, the number of people from an ethnic minority background in these studies was very small (4%), so we could not look at differences in cancer fear between different ethnic groups.

We have now extended these findings in a study which was published in the British Journal of Cancer today [4].  In this study, we compared levels of cancer fear and fatalism across 720 women from White British, Caribbean, African, Indian, Pakistani and Bangladeshi backgrounds, and examined where these differences may come from.  The study was part of a larger study on cervical cancer screening in women from ethnic minority backgrounds [5].

Our findings confirm that cancer fear is still very prevalent: about a quarter of all women feared cancer more than other diseases, or felt uncomfortable at the thought of it.  And about one in five women said they worried a lot about cancer.  There were few differences between the ethnicities, although Indian and African women seemed a bit more afraid of cancer (33%), and Bangladeshi women a little less (15%) on some indicators of fear.

Apart from cancer fear, we also looked at cancer fatalism, which was defined as a belief that cancer is predetermined and that it is incurable.  Here, some striking differences were found between the ethnic groups: almost a quarter of Caribbean women (23%), and more than half of Indian, Pakistani, and Bangladeshi women (50, 52, and 63%, respectively) believed that a diagnosis of cancer was down to fate, compared with only 6% of White British women.  In addition, a quarter to over a third (26-38%) of women from an ethnic minority background thought that cancer was incurable, but no White British women did.

We explored whether these fearful and fatalistic attitudes among women from ethnic minority backgrounds could be explained by level of acculturation and the belief that events in life are generally predetermined.  We found that not speaking English very well or having difficulty understanding health-related information was associated with being more likely to feel uncomfortable about cancer and believing that a diagnosis of cancer is predetermined.  However, these characteristics were also associated with being less likely to worry about cancer or fearing cancer more than other diseases.  Perhaps unsurprisingly, we also found that a belief that events in life are generally predetermined was associated with the belief that a diagnosis is predetermined, too.

Our study is one of the first studies to explore cancer fear and fatalism in different ethnic minority groups in the UK.  Our findings show that cancer worry is still pervasive in the UK, with no stark differences between ethnic groups, but fatalistic beliefs about cancer seem much more prevalent among those from an ethnic minority background.  These findings may help explain why women from ethnic minority backgrounds are less likely to attend cancer screening or to go to their doctor with symptoms [5].  Our findings also have implications for public health campaigns.  For example, those who do not speak English very well were more fatalistic and uncomfortable about cancer, suggesting that messages of increased survival may not reach these groups.

Further research should address the link between cancer fear and fatalism among different ethnic groups, and engagement with cancer early diagnosis directly, to help inform more targeted public health campaigns.

Charlotte discussed the findings of this study with DJ Nihal in his radio show on the BBC Asian Network on 7 March 2016, where it formed the starting point for an open discussion about cancer, fate, and stigma in the Asian community (from 1:12 onwards).


[1] Vrinten C, Waller J, von Wagner C, & Wardle J. (2015). Cancer fear: facilitator and deterrent to participation in colorectal cancer screening. Cancer Epidemiology Biomarkers & Prevention, 24(2), 400-405.

[2] Beeken RJ, Simon AE, von Wagner C, Whitaker KL, & Wardle J. (2011). Cancer fatalism: deterring early presentation and increasing social inequalities? Cancer Epidemiology Biomarkers & Prevention, 20(10), 2127-2131.

[3] Vrinten C, van Jaarsveld CH, Waller J, von Wagner C, & Wardle J. (2014). The structure and demographic correlates of cancer fear. BMC Cancer, 14, 597-605.

[4] Vrinten C, Wardle J, & Marlow LA. (2016). Cancer fear and fatalism among ethnic minority women in the United Kingdom. British Journal of Cancer. Advance online publication 11 February 2016; doi: 10.1038/bjc.2016.15

[5] Marlow LAV, Wardle J, & Waller J. (2015). Understanding cervical screening non-attendance among ethnic minority women in England. British Journal of Cancer, 113(5), 833-839.

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