Exploring the role of cancer fatalism and engagement with skin cancer genetic information in diverse primary care patients

Author:

Hay Jennifer L.1ORCID,Wu Yelena23,Schofield Elizabeth1,Kaphingst Kim4,Sussman Andrew L.5,Guest Delores D.6,Hunley Keith7,Li Yuelin1,Buller David8,Berwick Marianne910

Affiliation:

1. Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center New York New York USA

2. Huntsman Cancer Institute University of Utah Health Sciences Center Salt Lake City Utah USA

3. Department of Dermatology University of Utah Health Sciences Center Salt Lake City Utah USA

4. Cancer Communication Research Huntsman Cancer Institute University of Utah Salt Lake City Utah USA

5. Department of Family and Community Medicine University of New Mexico Albuquerque New Mexico USA

6. University of New Mexico Comprehensive Cancer Center Albuquerque New Mexico USA

7. Department of Anthropology University of New Mexico Albuquerque New Mexico USA

8. Klein Buendel, Inc. Golden Colorado USA

9. Department of Internal Medicine University of New Mexico Albuquerque New Mexico USA

10. Department of Dermatology University of New Mexico Albuquerque New Mexico USA

Abstract

AbstractObjectiveTo broaden the currently limited reach of genomic innovations, research is needed to understand how psychosocial and cultural factors influence reactions to genetic testing in diverse subgroups. Cancer fatalism is important in cancer prevention and deserves theoretical and empirical attention in the context of genomics and behavior change.MethodsThe current study employed data from a randomized controlled trial (N = 593) offering skin cancer genetic testing (using the melanocortin‐1 receptor [MC1R] gene) in primary care in Albuquerque, New Mexico, USA. We examined interrelations of cancer fatalism with demographics, general health beliefs, perceived risk, perceived control, sun protection and skin screening behaviors and cancer worry in the skin cancer context stratified across Hispanic versus non‐Hispanic ethnicity, and examined cancer fatalism as a moderator of intervention effects on study primary outcomes, including 3‐month sun protection, cancer worry and perceived risk.ResultsCancer fatalism was significantly related to the perception of control over skin cancer risk behaviors (ps ≤ 0.01) and demographics (ethnicity, education, health literacy; ps < 0.05), but not consistently related to general health beliefs or risk perception. Cancer fatalism did not moderate intervention effects on primary outcomes, except those with higher cancer fatalism randomized to intervention had higher levels of 3‐month cancer worry (p = 0.019).ConclusionsThese findings will guide future work considering the role of cancer fatalism in use of genomic technologies in the general population. This work anticipates strategies required to address cancer fatalism as translational genomics becomes more commonly available to diverse general population subgroups.

Funder

National Institutes of Health

Publisher

Wiley

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