Cancer Fatalism: Attitudes Toward Screening and Care

Cancer fatalism is the perception that encountering cancer is a certain death sentence and that sooner or later, the individual with cancer will die. This chapter provides a critical review of studies focused on different aspects of cancer fatalism, including its prevalence in different population groups, correlates of fatalism with sociodemographic variables, fatalism as a barrier to screening, and fatalism as a factor in the delay of diagnosis and receiving treatment. Cancer fatalism is a widespread belief in Western countries, especially but not solely among individuals from more traditional ethnic groups. Cancer fatalism has often been reported to be related to less healthy lifestyles and lower rates of attending screenings for breast, colorectal, and cervical cancer. Only a few studies examined fatalism among cancer patients and generally found that although many believed that cancer was a matter of fate or genetics, they mostly denied the fatalistic view of cancer as causing certain death. However, mixed results have been obtained in studies comparing the range and intensity of fatalistic beliefs among individuals from different ethnic groups and their effects after controlling for demographic variables. These complex results point to the complexity of the structure of fatalism that requires considering the interrelations among cultural, structural, and individual factors. This chapter outlines a multidimensional conceptualization of cancer fatalism featuring four dimensions: fatalistic beliefs of cancer occurrence and outcome; causal attributions of cancer (divine providence, chance, genetics, or environmental factors); antecedents of fatalistic beliefs (personal or sociodemographic factors); and outcomes of fatalistic beliefs (adherence to screening or treatment).