Cancer Fatalism and Health Disparities

Quality Interactions 

Fatalistic health beliefs can contribute to racial/ethnic health disparities.[1,2,3,4] Cancer fatalism, the health belief that death is inevitable when cancer is present, has been linked to low cancer screening rates, delays in cancer treatment after diagnosis, and reluctance to engage in healthy lifestyle behaviors to reduce cancer risk. In each case, patients with fatalistic health beliefs feel that there is nothing they can do to prevent cancer or avoid death from cancer. The belief is that death is simply their fate. Low cancer screening and delays in treatment reduce cancer survival and can inadvertently reinforce the belief that cancer is always fatal.

Research demonstrates that cancer fatalism is prevalent across cultural groups, including Asians, African Americans and Hispanics.[2,3,4] Indeed, fatalism beliefs are often cited as the reason family members of cancer patients will request to withhold a cancer diagnosis from a loved one; believing that knowledge of the cancer diagnosis will diminish the patient's will to live and expedite death.[5] Another cancer health belief common among African American pulmonary patients and lung cancer clinic patients facing lung surgery, is that the cancer will spread rapidly at surgery.[6] Such health beliefs may result in patients refusing disease-modifying surgery, contributing to the higher lung cancer death rates found among African Americans.

These results highlight the importance of providing culturally sensitive medical care. Providers need a heightened awareness of cultural values and beliefs that impact patient care. Health beliefs should be explored during the medical encounter to address potential barriers to cancer screening and reduce racial/ethnic disparities in cancer survival rates.

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