1
|
Goethe VE, Dinkel A, Schulwitz H, Nöhreiter A, Gschwend JE, Herkommer K. [What causes prostate cancer: patient-perceived causes]. Aktuelle Urol 2021; 52:136-142. [PMID: 31594005 DOI: 10.1055/a-1005-6273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Psychosocial distress caused by prostate cancer (PCa) can persist in patients for years after treatment. A possible factor in this context is the subjectively perceived cause of the disease, which can have a significant influence on the experience of distress, therapy adherence and preventive behaviour. The aim of this study was to record subjective reasons for PCa in long-term survivors and to investigate associated factors. MATERIAL AND METHODS PCa survivors from the national research project "Familial Prostate Cancer" were included in the study. As part of the annual postal follow-up questionnaire, PCa survivors were asked about subjectively perceived causes of their PCa. Responses were assigned to 18 possible categories. In addition, the association between the subjectively perceived causes of PCa and secondary tumours, a positive family history of tumour diseases and sociodemographic factors was investigated. RESULTS Of the 9 047 PCa survivors surveyed, 4 054 (44.8 %) provided information on the subjectively perceived causes of their PCa and were included in this analysis. The mean time since diagnosis was 10.1 years with a mean age of 63.1 years at diagnosis. The most frequent responses were "don't know" (31.8 %), genetics (30.1 %) and stress (18.5 %). Age, the most important risk factor for PCa, was rarely mentioned (2.5 %). In addition to these responses, unusual non-evidence-based reasons were also reported. Men with a positive family history of PCa cited genetics as the cause of their disease about 4 times more frequently than sporadic cases. This proportion increased with the number of affected family members. PCa survivors aged ≤ 65 years at diagnosis indicated stress as the cause of their PCa approximately 2 times more often than men who were older than 65 years at PCa diagnosis. CONCLUSION Most men surveyed reported non-evidence-based causes of their PCa. Preventive programs should address the evidence-based causes more distinctly and with a high visibility. Due to the significance of lay illness beliefs for the experience of distress and the adherence to treatment, the patient's subjective cause of disease should be surveyed and considered by the urologist in charge.
Collapse
Affiliation(s)
- Veronika Elisabeth Goethe
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Andreas Dinkel
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Helga Schulwitz
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Alexandra Nöhreiter
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Jürgen Erich Gschwend
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| | - Kathleen Herkommer
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Urologie, München
| |
Collapse
|
2
|
Hamilton JG, Waters EA. How are multifactorial beliefs about the role of genetics and behavior in cancer causation associated with cancer risk cognitions and emotions in the US population? Psychooncology 2017; 27:640-647. [PMID: 29024169 DOI: 10.1002/pon.4563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/13/2017] [Accepted: 09/29/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE People who believe that cancer has both genetic and behavioral risk factors have more accurate mental models of cancer causation and may be more likely to engage in cancer screening behaviors than people who do not hold such multifactorial causal beliefs. This research explored possible health cognitions and emotions that might produce such differences. METHODS Using nationally representative cross-sectional data from the US Health Information National Trends Survey (N = 2719), we examined whether endorsing a multifactorial model of cancer causation was associated with perceptions of risk and other cancer-related cognitions and affect. Data were analyzed using linear regression with jackknife variance estimation and procedures to account for the complex survey design and weightings. RESULTS Bivariate and multivariable analyses indicated that people who endorsed multifactorial beliefs about cancer had higher absolute risk perceptions, lower pessimism about cancer prevention, and higher worry about harm from environmental toxins that could be ingested or that emanate from consumer products (Ps < .05). Bivariate analyses indicated that multifactorial beliefs were also associated with higher feelings of risk, but multivariable analyses suggested that this effect was accounted for by the negative affect associated with reporting a family history of cancer. Multifactorial beliefs were not associated with believing that everything causes cancer or that there are too many cancer recommendations to follow (Ps > .05). CONCLUSION Holding multifactorial causal beliefs about cancer are associated with a constellation of risk perceptions, health cognitions, and affect that may motivate cancer prevention and detection behavior.
Collapse
Affiliation(s)
- Jada G Hamilton
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Erika A Waters
- Department of Surgery-Division of Public Health Sciences, Washington University in St. Louis, St Louis, MO, USA
| |
Collapse
|
3
|
Waters EA, Ball L, Gehlert S. "I don't believe it." Acceptance and skepticism of genetic health information among African-American and White smokers. Soc Sci Med 2017; 184:153-160. [PMID: 28527373 PMCID: PMC5535773 DOI: 10.1016/j.socscimed.2017.04.053] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 04/07/2017] [Accepted: 04/29/2017] [Indexed: 12/11/2022]
Abstract
RATIONALE Effective translation of genomics research into practice depends on public acceptance of genomics-related health information. OBJECTIVE To explore how smokers come to accept or reject information about the relationship between genetics and nicotine addiction. METHODS Thirteen focus groups (N = 84) were stratified by education (seven < Bachelor's degree, six ≥ Bachelor's degree) and race (eight black, five white). Participants viewed a 1-min video describing the discovery of a genetic variant associated with increased risk of nicotine addiction and lung cancer. Next, they provided their opinions about the information. Two coders analyzed the data using grounded theory. RESULTS Pre-video knowledge about why people smoke cigarettes and what genetic risk means informed beliefs about the relationship between genes and addiction. These beliefs were not always consistent with biomedical explanations, but formed the context through which participants processed the video's information. This, in turn, led to information acceptance or skepticism. Participants explained their reactions in terms of the scientific merits of the research and used their existing knowledge and beliefs to explain their acceptance of or skepticism about the information. CONCLUSION Laypeople hold complex understandings of genetics and addiction. However, when lay and biomedical explanations diverge, genetics-related health information may be rejected.
Collapse
|
4
|
Tripp MK, Peterson SK, Prokhorov AV, Shete SS, Lee JE, Gershenwald JE, Gritz ER. Correlates of Sun Protection and Sunburn in Children of Melanoma Survivors. Am J Prev Med 2016; 51:e77-85. [PMID: 27067306 PMCID: PMC5482415 DOI: 10.1016/j.amepre.2016.02.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 02/04/2016] [Accepted: 02/26/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Sunburns during childhood increase melanoma risk. Children of melanoma survivors are at higher risk, but little is known about their sunburn and sun protection. One study showed that almost half of melanoma survivors' children experienced sunburn in the past year. This study evaluated sunburn and sun protection in melanoma survivors' children, and relevant survivor characteristics from Social Cognitive Theory and the Health Belief Model. METHODS Melanoma survivors (N=340) were recruited from a comprehensive cancer center. Survivors completed a baseline questionnaire administered by telephone to report on the behavior of their children (N=340) as part of an RCT of a sun protection intervention. Data were collected in 2008 and analyzed in 2015. RESULTS In the prior 6 months, 28% of children experienced sunburn. "Always" or "frequent" sun protection varied by behavior: sunscreen, 69%; lip balm, 15%; wide-brimmed hats, 9%; sleeved shirts, 28%; pants, 48%; sunglasses, 10%; shade, 33%; and limiting time outdoors, 45%. Survivors' sunburn and sun protection were positively associated with these outcomes in children. Correlates of sunburn also included older child age and higher risk perceptions. Correlates of sun protection behaviors included younger child age; stronger intentions, higher self-efficacy, and more positive outcome expectations about sun protection; and greater number of melanomas in survivors. CONCLUSIONS Melanoma survivors may have a heightened awareness of the importance of their children's sun protection, but their children are not routinely protected. Correlates of children's sunburn and sun protection suggest subgroups of survivors to target with interventions to improve sun protection.
Collapse
Affiliation(s)
- Mary K Tripp
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alexander V Prokhorov
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sanjay S Shete
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey E Lee
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey E Gershenwald
- Departments of Surgical Oncology and Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ellen R Gritz
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
5
|
Westhoff E, Maria de Oliveira-Neumayer J, Aben KK, Vrieling A, Kiemeney LA. Low awareness of risk factors among bladder cancer survivors: New evidence and a literature overview. Eur J Cancer 2016; 60:136-45. [DOI: 10.1016/j.ejca.2016.03.071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 03/15/2016] [Accepted: 03/17/2016] [Indexed: 10/21/2022]
|
6
|
Rodríguez VM, Gyure ME, Corona R, Bodurtha JN, Bowen DJ, Quillin JM. What women think: cancer causal attributions in a diverse sample of women. J Psychosoc Oncol 2015; 33:48-65. [PMID: 25398057 DOI: 10.1080/07347332.2014.977419] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Women hold diverse beliefs about cancer etiology, potentially affecting their use of cancer preventive behaviors. Research has primarily focused on cancer causal attributions survivors and participants from non-diverse backgrounds hold. Less is known about attributions held by women with and without a family history of cancer from a diverse community sample. Participants reported factors they believed cause cancer. Open-ended responses were coded and relations between the top causal attributions and key factors were explored. Findings suggest certain socio-cultural factors play a role in the causal attributions women make about cancer, which can, in turn, inform cancer awareness and prevention messages.
Collapse
Affiliation(s)
- Vivian M Rodríguez
- a Department of Psychiatry and Behavioral Sciences , Memorial Sloan Kettering Cancer Center , New York , NY , USA
| | | | | | | | | | | |
Collapse
|
7
|
Fitzpatrick L, Hay JL. Barriers to risk-understanding and risk-reduction behaviors among individuals with a family history of melanoma. Melanoma Manag 2014; 1:185-191. [PMID: 30190823 DOI: 10.2217/mmt.14.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Family members of melanoma patients are often called upon to provide support, ranging from monetary to medical assistance. Consanguineal relatives of melanoma patients are also at greater risk of developing the disease themselves. However, as a group, they have limited understanding of their melanoma risk and they demonstrate inadequate primary and secondary prevention behaviors. The optimal intervention strategies for improving the consistent use of such behaviors (i.e., improving rates of sun-protection behaviors and screening) remains unclear, necessitating further research.
Collapse
Affiliation(s)
- Laura Fitzpatrick
- Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA.,Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA
| | - Jennifer L Hay
- Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA.,Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY 10022, USA.,Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA.,Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY 10022, USA
| |
Collapse
|
8
|
Orom H, O'Quin KE, Reilly S, Kiviniemi MT. Perceived cancer risk and risk attributions among African-American residents of a low-income, predominantly African-American neighborhood. ETHNICITY & HEALTH 2014; 20:543-556. [PMID: 25145570 DOI: 10.1080/13557858.2014.950197] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE In some national surveys, African-Americans have had lower scores on perceived cancer risk items than whites. Our goals were to confirm low perceptions of cancer risk in an African-American community sample and explore participants' attributions for their perceived cancer risk. DESIGN Data were from three cross-sectional surveys. We report levels of perceived absolute and comparative cancer risk in a community sample of African-Americans (N = 88), and African-Americans (Ns = 655, 428) and whites (Ns = 5262, 1679) from two nationally representative Health Information National Trends Surveys (HINTS). We analyzed the content of spontaneously-provided explanations for perceived risk from the community sample. RESULTS Perceived absolute and comparative cancer risk were lower in the community and national samples of African-Americans than in the national sample of whites. Participants' spontaneous attributions for low or lower than average risk included not having family history or behavioral risk factors, classes of attributions noted elsewhere in the literature. However, participants also explained that they wanted to avoid wishing cancer on themselves (positive affirmations) and hoped their risk was low (wishful thinking), responses rarely reported for majority-white samples. CONCLUSIONS Results provide further evidence that cancer risk perceptions are lower among African-Americans than whites. Some participant explanations for low perceived risk (wishful thinking, affirmations) are inconsistent with behavioral scientists' assumptions about perceived risk questions. Results reveal a need to expand cancer risk attribution typologies to increase applicability to diverse populations, and may indicate that perceived cancer risk questions have lower validity in African-American populations.
Collapse
Affiliation(s)
- Heather Orom
- a Department of Community Health and Health Behavior , University at Buffalo , Buffalo , NY , USA
| | | | | | | |
Collapse
|
9
|
Gritz ER, Tripp MK, Peterson SK, Prokhorov AV, Shete SS, Urbauer DL, Fellman BM, Lee JE, Gershenwald JE. Randomized controlled trial of a sun protection intervention for children of melanoma survivors. Cancer Epidemiol Biomarkers Prev 2014; 22:1813-24. [PMID: 24097199 DOI: 10.1158/1055-9965.epi-13-0249] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We studied whether a melanoma survivor-centered intervention was more effective than materials available to the general public in increasing children's sun protection. METHODS In a randomized controlled trial, melanoma survivors (n = 340) who had a child ≤ 12 years received a targeted sun protection intervention (DVD and booklets) or standard education. Primary outcomes were children's sunburns, children's sun protection, and survivors' psychosocial factors at baseline and postintervention (1 and 4 months). RESULTS The intervention increased children's sunscreen reapplication at 1 month (P = 0.002) and use of wide-brimmed hats at 4 months (P = 0.045). There were no effects on other behaviors or sunburns. The intervention improved survivors' hats/clothing self-efficacy at both follow-up assessments (P = 0.026, 0.009). At 4 months, the intervention improved survivors' clothing intentions (P = 0.029), knowledge (P = 0.010), and outcome expectations for hats (P = 0.002) and clothing (P = 0.037). Children's sun protection increased with survivors' intervention use. The intervention was less effective in survivors who were female or who had a family history, older children, or children with higher baseline sun protection scores. CONCLUSIONS A melanoma survivor-centered sun protection intervention can improve some child and survivor outcomes. The intervention may be more effective in survivors who have younger children or less experience with sun protection. Intervention delivery must be enhanced to maximize use. IMPACT This is the first study to examine a sun protection intervention for children of melanoma survivors. Findings will guide interventions for this important population at increased melanoma risk.
Collapse
Affiliation(s)
- Ellen R Gritz
- Authors' Affiliation: The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Orom H, Kiviniemi MT, Shavers VL, Ross L, Underwood W. Perceived risk for breast cancer and its relationship to mammography in Blacks, Hispanics, and Whites. J Behav Med 2013; 36:466-76. [PMID: 22772713 PMCID: PMC3565065 DOI: 10.1007/s10865-012-9443-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 06/20/2012] [Indexed: 12/23/2022]
Abstract
A challenge for health behavior science is to develop theory and best practices that take cultural diversity into account. Using data from Black, Hispanic, and White respondents to the 2003 Health Information National Trends Survey, we examined racial/ethnic differences in: (1) breast cancer risk perceptions/worry; (2) the associations between perceived risk/worry and ever having received a mammogram; and (3) perceived risk/worry and having had at least 2 mammograms over a 4-year period (consecutive mammography). Compared to White race/ethnicity, Black race/ethnicity was associated with lower perceived absolute risk and comparative risk for developing cancer. For the sample as a whole, higher perceived risk (both absolute risk and comparative risk) and worry predicted greater odds of mammography use; however, this was not true for Hispanics. In stratified analyses, perceived risk and worry were not associated with mammography use for either Hispanics or Blacks whereas they were for Whites; however, this interaction effect was significant only for Hispanics vs. Whites. Results support the need for formative research to identify determinants of health behavior prior to cancer prevention message planning for diverse audiences in order to accommodate racial/ethnic differences not only in the level of perceived risk, but also the association between risk perception to behavior change in that community.
Collapse
Affiliation(s)
- Heather Orom
- Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY 14214, USA.
| | | | | | | | | |
Collapse
|
11
|
Gaber R, Desai S, Smith M, Eilers S, Blatt H, Guevara Y, Robinson JK. Communication by mothers with breast cancer or melanoma with their children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3483-501. [PMID: 23965923 PMCID: PMC3774450 DOI: 10.3390/ijerph10083483] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 07/26/2013] [Accepted: 07/30/2013] [Indexed: 11/17/2022]
Abstract
Communication of familial risk of breast cancer and melanoma has the potential to educate relatives about their risk, and may also motivate them to engage in prevention and early detection practices. With the Health Insurance Portability and Accountability Act (HIPAA) privacy laws, the patient often becomes the sole communicator of such risks to family members. This study surveys mothers diagnosed with either breast cancer or melanoma and their adult children about their family communication style, knowledge of increased risk, and early detection practices. In both cancer groups, most mothers alerted their children of the risk and need for early detection practices. Breast cancer mothers communicated risk and secondary prevention with early detection by breast self-examination and mammograms whereas the melanoma mothers communicated risk and primary prevention strategies like applying sunscreen and avoiding deliberate tanning. Open communication about health matters significantly increased the likelihood that children engaged in early detection and/or primary prevention behaviors. Examining the information conveyed to at-risk family members, and whether such information motivated them to engage in early detection/prevention behaviors, is key to guiding better cancer prevention communication between doctors and patients.
Collapse
Affiliation(s)
- Rikki Gaber
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; E-Mails: (R.G.); (S.D.); (S.E.); (H.B.); (Y.G.)
| | - Sapna Desai
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; E-Mails: (R.G.); (S.D.); (S.E.); (H.B.); (Y.G.)
| | - Maureen Smith
- Center for Genetic Counseling, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; E-Mail:
| | - Steve Eilers
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; E-Mails: (R.G.); (S.D.); (S.E.); (H.B.); (Y.G.)
| | - Hanz Blatt
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; E-Mails: (R.G.); (S.D.); (S.E.); (H.B.); (Y.G.)
| | - Yanina Guevara
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; E-Mails: (R.G.); (S.D.); (S.E.); (H.B.); (Y.G.)
| | - June K. Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; E-Mails: (R.G.); (S.D.); (S.E.); (H.B.); (Y.G.)
| |
Collapse
|