Cancer fatalism and adherence to national cancer screening guidelines: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Cancer Epidemiol. 2019 Jun;60:39-45. doi: 10.1016/j.canep.2019.03.003. Epub 2019 Mar 21.


Background: Sociocultural factors, such as health insurance status, income, education, and acculturation, predict cancer screening among U.S. Hispanics/Latinos. However, these factors can be difficult to modify. More research is needed to identify individual-level modifiable factors that may improve screening and subsequent cancer outcomes in this population. The aim of this study was to examine cancer fatalism (i.e., the belief that there is little or nothing one can do to lower his/her risk of developing cancer) as a determinant of adherence to national screening guidelines for colorectal, breast, prostate, and cervical cancer among Hispanics/Latinos.

Methods: Participants were from the multi-site Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (N = 5313). The National Cancer Institute (NCI) Health Interview National Trends Survey was used to assess cancer fatalism and receipt of cancer screening. Adherence was defined as following screening guidelines from United States Preventive Services Task Force and the American Cancer Society during the study period.

Results: Adjusting for well-established determinants of cancer screening and covariates (health insurance status, income, education, acculturation, age, Hispanic/Latino background), lower cancer fatalism was marginally associated with greater adherence to screening for colorectal (OR 1.13, 95% CI [.99-1.30], p = .07), breast (OR 1.16, 95% CI [.99-1.36], p = .08) and prostate cancer (OR 1.18, 95% CI [.97-1.43], p = .10), but not cervical cancer.

Conclusions: The associations of cancer fatalism were small and marginal, underlining that sociocultural factors are more robust determinants of cancer screening adherence among Hispanics/Latinos.

Keywords: Adherence; Cancer prevention; Cancer screening; Fatalism; Health beliefs; Hispanic; Latino.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acculturation
  • Adult
  • Aged
  • Early Detection of Cancer / psychology*
  • Early Detection of Cancer / statistics & numerical data
  • Female
  • Guideline Adherence / standards
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / diagnosis*
  • Neoplasms / epidemiology
  • Neoplasms / ethnology
  • Neoplasms / psychology*
  • Public Health
  • Risk Factors
  • United States