Perceptions of cancer risk communication in individuals with overweight or obesity- a qualitative interview study

Åsa Grauman; Erica Sundell; Jessica Nihlén Fahlquist; Mariann Hedström

doi:10.1186/s12889-025-23056-w

Perceptions of cancer risk communication in individuals with overweight or obesity- a qualitative interview study

BMC Public Health. 2025 May 23;25(1):1900. doi: 10.1186/s12889-025-23056-w.

Authors

Åsa Grauman¹, Erica Sundell², Jessica Nihlén Fahlquist², Mariann Hedström³

Affiliations

¹ Centre for Research Ethics and Bioethics, Uppsala University, Box 564, Uppsala, SE-751 22, Sweden. asa.grauman@uu.se.
² Centre for Research Ethics and Bioethics, Uppsala University, Box 564, Uppsala, SE-751 22, Sweden.
³ Department of Public Health and Caring Sciences, Uppsala University, Box 564, Uppsala, SE-751 22, Sweden.

Abstract

Background: Addressing obesity and overweight is crucial for cancer prevention. However, ensuring that such efforts do not harm individuals with obesity requires careful consideration to avoid reinforcing the widespread stigmatisation of individuals with obesity. This study aims to explore how individuals who have overweight or obesity perceive cancer risk information addressing obesity as a cancer risk factor.

Methods: Semi-structured interviews were conducted during autumn 2023 and spring 2024, with 11 Swedish men and women, aged 24 to 70 years, who self-assessed as having overweight or obesity. The collected data were analysed using reflexive thematic analysis as described by Braun and Clarke.

Results: The first theme, Reflecting on personal risk, included the subthemes: It is about me and my body and Awareness can be a burden. The second theme, Healthcare encounters: building trust and providing support, included the subthemes: Past encounters influence how risk information is perceived, Need to act and succeed, and Consider receptivity and power imbalances. The third theme, Distribution of responsibility and blameworthiness, included subthemes: Being personally blamed and fearing increased discrimination and A need for shared responsibility.

Conclusion: Participants experienced that risk information, when presented as simplified associations between obesity and cancer, felt personally relevant but difficult to act upon, and therefore burdensome to bear. Consequently, the information risks failing to prevent cancer and may instead cause harm to the people it purports to benefit. Participants suggested several ways to improve the provision and benefit of such information, including introducing multiple ways to act to reduce cancer risk that goes beyond weight reduction, and raising public awareness of the causes of obesity. Efforts to communicate risk, both to the public and to patients, require better ethical considerations of their benefits and harms. Furthermore, risk communicators should act with compassion and responsibility.

Keywords: Cancer; Obesity; Overweight; Prevention; Qualitative research, stigma; Risk communication.

MeSH terms

Adult
Aged
Communication*
Female
Humans
Interviews as Topic
Male
Middle Aged
Neoplasms* / etiology
Neoplasms* / prevention & control
Neoplasms* / psychology
Obesity* / complications
Obesity* / psychology
Overweight* / complications
Overweight* / psychology
Qualitative Research
Risk Assessment
Risk Factors
Sweden
Young Adult