Fifty shades of cancer fear
By Charlotte Vrinten, on 7 October 2016
Are you afraid of cancer? Don’t worry, you’re in good company. Surveys show that many people in the UK are afraid of cancer : 35% of people fear cancer more than other serious illnesses such as heart disease or HIV , and 20% fear cancer more than being in debt, being in a car accident, or losing a job.  But although we know that lots of people find cancer frightening, we don’t really know what it is about cancer that they are afraid of. So in our latest study, we aimed to explore just that.
You may wonder why it is important to pinpoint what it is about cancer that worries people. The answer is that the nature of the fear may determine how people behave when it comes to cancer screening or responding to suspicious symptoms. For example, a study in the US found that worry about prostate cancer motivated men to have a prostate examination, while fear of the examination put them off. Intuitively, we know that there are many different aspects to cancer that could be frightening, but until now, no one had really explored this.
In our study, which was published today, we collated findings from 102 interview studies from 26 countries to see what people in the general population(as opposed to cancer patients) said they feared about cancer . All the studies combined included more than 3,500 participants.
We found that those who are afraid of cancer seemed to view cancer as an indestructible enemy that randomly sneaks up on people to kill them – reprising the media’s ‘war on cancer’ theme. This rogue super soldier inspired lots of fear, which could be increased or decreased by factors such as family history of cancer, symptoms, or experiences of cancer in others, as well as coping styles such as ‘checking up on the enemy’ through cancer screening, or pretending that it doesn’t exist.
In addition, we found that there are also specific aspects of cancer that inspire fear. Many participants were fearful of the emotional upset that a cancer diagnosis would cause. Fears of cancer treatment, such as chemotherapy and surgery, were also mentioned in many studies, in addition to the fear that surgery might cause cancer to spread (a fear that is completely unfounded). Some women expressed fears about losing intimate body parts and thereby their gender identity, for example if a breast needed to be removed to treat breast cancer.
The social implications of being a cancer patient also inspired a lot of fear. Some people feared that a cancer diagnosis would stigmatise them, or would attract blame. Many people also worried that a cancer diagnosis would have a negative effect on their family, by burdening them financially, physically, or psychologically. Some women were worried that losing a breast would mean that their partners would no longer find them attractive and might abandon them.
Finally, we found many references to fears about dying from cancer. Some said that they were so afraid of dying from cancer that they’d rather die without knowing that they had it.
What can we conclude from these findings? We have shown for the first time that there are many different things that people in the general population – without a cancer diagnosis – worry about when it comes to cancer. What we do not yet know is how common these worries are, and how they may influence willingness to take steps to reduce cancer risk or get it detected early. These are questions that we will be investigating further. For example, we recently completed a national survey to find out how common various cancer worries are, the results of which will be presented at the upcoming NCRI conference. Watch this space!
 Consedine NS, Adjei BA, Ramirez PM, McKiernan JM. (2008). An object lesson: source determines the relations that trait anxiety, prostate cancer worry, and screening fear hold with prostate screening frequency. Cancer Epidemiology Biomarkers & Prevention, 17(7), 1631-1639.
 Vrinten C, McGregor LM, Heinrich M, von Wagner C, Waller J, Wardle J, Black GB. (2016). What do people fear about cancer? A systematic review and meta-synthesis of cancer fears in the general population. Psychooncology, Epub 6 Oct 2016.