Association of political ideology and fatalistic cancer beliefs

Introduction : Cancer fatalism is linked to lower adherence to cancer screening and poor preventive health behaviors. Race, health information and social factors have been associated with cancer fatalism, however there is limited research on association with political orientation. Methods : Data from the National Cancer Institute's Health Information National Trends Survey (HINTS) 7, conducted from March 25 - September 16, 2024, was used. This is a publicly available, de-identified, nationally representative survey of non-institutionalized civilian US adults and is thus exempt from institutional review board review. Survey response rate was 27.3%, with over 86% responding to the specific questions on fatalistic cancer beliefs and political ideology. Primary outcome was fatalistic cancer beliefs assessed using four items in the HINTS survey, each re-coded into a dichotomous variable of strongly agree/somewhat agree vs. strongly disagree/somewhat disagree for this study. Political ideology and race were self-reported. Multivariable logistic regression (adjusted for age, sex, race/ethnicity, educational level, household income, personal cancer history and rural-urban residence) was carried out for each fatalistic belief and political ideology. Statistical analyses were performed using Stata 18.0 software (StataCorp LLC) with 2-sided significance at p  < .05 Results : The study sample included 6267 adults [3708 (48.3%) women, 3386 non-Hispanic White (61%), and 5400 (87.2%) urban residents. 2033 (31.9%) self-reported as conservative, 2232 (37.5%) as moderate, and 2002 (30.6%) as liberal. Adjusted logistic regression models showed that conservative participants, compared with liberals and moderates were more likely to say they strongly agree/somewhat agree that it seems everything causes cancer [adjusted odds ratio (aOR), 1.47; 95% CI, 1.27-1.69 and 1.29; 95% CI, 1.12-1.49 respectively]. Similarly, when statements on “there is not much you can do to lower your chances of getting cancer” and “there are so many different recommendations about preventing cancer, it's hard to know which ones to follow” were analyzed, conservative participants were more likely to strongly agree/somewhat agree compared with liberal participants [aOR 1.46; 95% CI, 1.26-1.70 and 1.51; 95% CI, 1.32-1.78 respectively] and moderate participants [aOR 1.41; 95% CI, 1.22-1.63 and 1.57; 95% CI, 1.36-1.81 respectively]. There was no significant difference in the statement “When I think about cancer, I automatically think about death” across political ideologies. Conclusions : In this nationally representative survey of US adults, significant association exists between political ideology and cancer fatalism statements. Given that cancer fatalism has been linked to decrease in screening uptake and health behaviors, political ideologies should be considered as a factor for culturally appropriate interventions, and health promotion strategies.