Cancer-Related Beliefs and Perceptions in Appalachia: Findings from 3 States


BACKGROUND: Appalachians experience increased rates of cancer incidence and mortality compared to non-Appalachians. Many factors may contribute to the elevated cancer burden, including lack of knowledge and negative beliefs about the disease.

METHODS: Three National Cancer Institute (NCI)-designated cancer centers with Appalachian counties in their respective population-based geographic service areas-Kentucky, Ohio, and Pennsylvania-surveyed their communities to better understand their health profiles, including 5 items assessing cancer beliefs. Weighted univariate and bivariate statistics were calculated for each of the 3 state’s Appalachian population and for a combined Appalachian sample. Weighted multiple linear regression was used to identify factors associated with a cancer beliefs composite score. Data from the combined Appalachian sample were compared to NCI’s Health Information National Trends Survey (HINTS).

RESULTS: Data from 1,891 Appalachian respondents were included in the analysis (Kentucky = 798, Ohio = 112, Pennsylvania = 981). Significant differences were observed across the 3 Appalachian populations related to income, education, marital status, rurality, perceptions of present income, and body mass index (BMI). Four of 5 cancer beliefs were significantly different across the 3 states. Education, BMI, perceptions of financial security, and Kentucky residence were significantly associated with a lower composite score of cancer beliefs. When comparing the combined Appalachian population to HINTS, 3 of 5 cancer belief measures were significantly different.

CONCLUSIONS: Variations in cancer beliefs were observed across the 3 states‘ Appalachian populations. Interventions should be tailored to specific communities to improve cancer knowledge and beliefs and, ultimately, prevention and screening behaviors.


Citation: Vanderpool, R. C., Huang, B., Deng, Y., Bear, T. M., Chen, Q., Johnson, M. F., Paskett, E. D., Robertson, L. B., Young, G. S., & Iachan, R. (2019). Cancer-related beliefs and perceptions in Appalachia: Findings from 3 states. J Rural Health, 35(2), 176-188. doi: 10.1111/jrh.12359

Link to Full Publication