Cancer is a complex disease and the accountability for being affected is a scientific, symbolic and even a political issue. Beliefs in specific causative factors may also impact on cancer screening behaviors. Taking advantage of the EDIFICE iterative national health surveys on cancer screening we investigated how lay people perceive the cause(s) of cancer occurrence.

Three causality classifications were used. Firstly, “external” (exogenous model) versus “internal” (endogenous) causes were assessed. Then we asked the interviewed persons to choose 2 from the following list of five causes: lifestyle, external pollution, heredity, increased life span, random (bad luck). Lastly, based on that classification and corresponding answers we created two categories (not including the overall sample): Under control: solely for lifestyle as an answer versus Out of control: for any other answers except lifestyle.

Screening behaviors were assessed according to the declared rate of cancer screening for breast, colorectal and prostate cancer (within the last two years for breast and colorectal cancer).

External causes and internal causes were almost equally divided (47% (759/1603) and 44% (704/1603) respectively with 9% (140/1603) having no idea). Women more often than men attributed cancer to an internal cause (49% (402/829) versus 39% (302/774); OR 1.47 [1.21 – 1.80]). As age increased, the rate of the undecided group increased from 6% (31/521) for the 40-49 years old to 15% (25/168) for the 70-75 years old (p<0.01). Interestingly there was no impact of personal history of cancer, nor if a friend or a relative had been affected by cancer, on the distribution of external/internal causes.

Among the five proposed cancer causes, 57% (911/1603) of our sample quoted lifestyle, 54% (861/1603) external pollution, 43% (688/1603) heredity, 15% increased life span (243/1603) and 14% (218/1603) random (bad luck). The younger population (40 to 49) blamed pollution more often than older people (50 to 74) (59% (305/521) versus 52% (551/1061), p<0.05).

It is widely assumed that causation belief impacts on preventive behaviors. In contrast in our survey, despite differences in causation beliefs, we found no significant impact of perceived causality on screening behaviors. Indeed, we compared the rate of screening attendance for breast, colorectal and prostate cancer between persons who thought cancer risks might be under control versus out of control and those who thought cancer risks originate in the body (internal) versus external causation. None of these 6 comparisons was statistically significant.

Compliance to cancer screening recommendations thus appears to be independent of perceived cancer causality.

Citation Format: François Eisinger, Jean-François Morère, Chantal Touboul, Xavier Pivot, Yvan Coscas, Jean-Yves Blay, Christine Lhomel, Jérôme Viguier. Perceived causality of cancer and screening behaviors. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr B03.

©2012 American Association for Cancer Research.
2012