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When Cancer Risk Feels Out of Our Control

Believing cancer risk is beyond our control may discourage healthy behaviors.

Key points

  • Cancer is the leading cause of avoidable death in the UK.
  • Cancer is broadly perceived as an uncontrollable risk, which may discourage the exact behaviors that could reduce its risk.
  • The causal pathways between behaviors and specific cancers are often not obvious, making general prevention advice more helpful.

Recent research has investigated perceptions of control over different causes of death, and their influence on health behaviors.

Cancer and avoidable deaths

The Office for National Statistics’ recent report on mortality statistics found that cancer is the largest driver of avoidable death in the UK. Avoidable mortality refers to deaths that are either preventable through effective public health strategies or treatable through timely and effective healthcare interventions.

Though there is a myriad of causes that may lead to avoidable death, a large portion of fatalities could be evaded by improving health behaviors. This suggests that one of the key strategies in the fight against cancer is encouraging people to live healthier lives.

Beliefs about control

Research suggests that investigating perceptions of control over risk may help to inform interventions aimed at improving health behaviors. For example, studies have shown that feeling you have little control over what might kill you predicts lower investment in health.

Given the relationship between beliefs about control and health behaviors, identifying causes of death that are widely felt to be uncontrollable may help to understand differences in people’s health behaviors. For example, those who believe their risk of dying from cancer is beyond their control, due to their environment or family medical history, may be less motivated to engage in the exact behaviors that could help to reduce their risk.

Pinning down specific causes of death commonly believed to be uncontrollable, as well as the origins of those beliefs, may help policymakers to produce structural interventions aimed at generating healthier lifestyles.

Beliefs about cancer

The new research, from myself and colleagues at Northumbria University, recently examined beliefs about control over different causes of death by interviewing participants from the North East of England. We found that, though dying from heart disease was widely described as being controllable, dying from cancer was broadly felt to be an uncontrollable risk. Those who felt some cancer risk was under their control mostly referred to their belief that lung cancer could be avoided by not smoking. However, the risk of dying due to other cancers was predominantly viewed as simply being down to bad luck.

Cancer and health behaviors

We found it striking that there was typically no discussion of health and lifestyle or external causal factors with respect to dying from specific cancers, suggesting that managing cancer risk through healthy living may not be on everyone’s radar.

This highlights previous research that found that the causal pathways between behaviors and specific cancers are often not obvious to individuals. For example, the way in which smoking may lead to lung cancer can be easily understood. It appears obvious to the individual that breathing in a harmful substance could subsequently result in lung damage. However, understanding the established links between alcohol and breast cancer may be less salient to the individual. Drinking an alcoholic beverage has no immediate connection to a woman’s breast, making it more difficult to associate the behavior with the risk.

Researchers have suggested that, due to the fact that causal pathways for specific types of cancer can be hard to pin down, public health policies should focus on general, rather than specific cancer risks. Informing the public of the key dietary factors associated with general cancer risk (obesity and alcohol) may help to encourage healthier habits without requiring people to conceptualise the complex causal links between specific behaviors and risk. Healthier eating and drinking less alcohol provide clear targets for improved behaviors that may help to increase beliefs about control, specifically where there may be a high degree of uncertainty concerning the triggers of cancer.