The role of sex and rurality in cancer fatalistic beliefs and cancer screening utilization in Florida

Abstract

Background: People's fatalistic beliefs about cancer can influence their cancer prevention behaviors. We examined the association between fatalistic beliefs and breast and colorectal cancer screening among residents of north-central Florida and tested whether there exists any sex or rural–non-rural disparities in the association. Methods: We conducted a cross-sectional, random digit dialing telephone survey of 895 adults residing in north-central Florida in 2017. Using weighted logistic models, we examined the association between (1) respondents’ sociodemographic characteristics and cancer fatalistic beliefs and (2) cancer fatalistic beliefs and cancer screening utilization among screening eligible populations. We tested a series of sex and rurality by fatalistic belief interactions. Results: Controlling for sociodemographics, we found the agreement with “It seems like everything causes cancer” was associated with a higher likelihood of having a mammogram (odds ratio [OR]: 3.34; 95% confidence interval [CI]: 1.17–9.51), while the agreement with “Cancer is most often caused by a person's behavior or lifestyle” was associated with a higher likelihood of having a blood stool test (OR: 1.85; 95% CI: 1.12–3.05) or a sigmoidoscopy or colonoscopy among women (OR: 2.65; 95% CI: 1.09–6.44). We did not observe any rural–non-rural disparity in the association between fatalistic beliefs and cancer screening utilization. Conclusions: Some, but not all, cancer fatalistic beliefs are associated with getting breast and colorectal cancer screening in north-central Florida. Our study highlights the need for more research to better understand the social and cultural factors associated with cancer screening utilization.