#6-S breast cancer fatalism: Ethnic differences and association with cancer screening

PURPOSE: Previous studies show that rural, elderly African Americans have higher colorectal cancer (CRC) fatalism (the belief that cancer is unpreventable and untreatable) compared to Whites and CRC fatalism predicts CRC screening. Research examining the association between fatalism and other forms of cancer screening is limited. The current study investigates breast cancer fatalism as a predictor of breast and cervical cancer adherence in a multi-ethnic sample of urban women. METHODS: Participants in this cross-sectional study were 25 African-American (AAW), 17 Hispanic (HW), and 19 White (WW) women in New York City (mean AGE = 42, SD = 17.04). Participants completed interviews assessing social demographics and adherence to American Cancer Society recommendations for mammography, clinical breast exam, and pap exam, and breast cancer fatalism. (Powe Fatalism Scale, (α = .79). RESULTS: AAW were more likely than HW and WW to endorse beliefs that one will die from breast cancer regardless of treatment (p < .04) and for some breast cancer is inevitable, regardless of physiciansʹ advice (p < .02). An ANOVA revealed ethnic differences in fatalism (F (2, 55)= 3.43, p < .04), AAW demonstrating higher scores than WW. This was no longer significant when income was controlled. There were no ethnic differences in cancer screening. Logistic regression revealed that fatalism was a marginally significant predictor of mammography non-adherence regardless of ethnicity (OR = 1.80, CI = .95, 3.43, p < .08) and significant predictor of pap test non-adherence (OR = 1.24, CI = 1.016, 1.50, p < .04) when controlling for demographics. CONCLUSION: Results show that ethnic differences in breast cancer fatalism are mediated by income, although AAW more strongly endorsed individual fatalism items. The associations between breast cancer fatalism and mammography and pap-test non-adherence suggest that not only is the fatalism construct applicable to other types of cancer but that women may not make substantial distinctions between different cancer types when describing related attitudes. Cancer fatalism may be important to address in cancer screening interventions regardless of the ethnicity of the target population.