Cancer Knowledge and Disparities in the Information Age

Harvard University School of Public Health and the Dana Farber Cancer Institute, Boston, Massachusetts 02115, USA.
Journal of Health Communication (Impact Factor: 1.61). 02/2006; 11 Suppl 1(sup001):1-17. DOI: 10.1080/10810730600637426
Source: PubMed


Increasing information flow often leads to widening gaps in knowledge between different socioeconomic status (SES) groups as higher SES groups are more likely to acquire this new information at a faster rate than lower SES groups. These gaps in knowledge may offer a partial but robust explanation for differential risk behaviors and health disparities between different social groups. Drawing on the Health Information National Trends Survey (HINTS 2003), a national survey of communication behaviors conducted by the National Cancer Institute (NCI), we examine the relationship between publicity and knowledge gaps on two cancer topics that received different levels of publicity: knowledge about tobacco and sun exposure and their respective links to cancer. Analyses of the HINTS 2003 data suggest that differential knowledge levels of causes of cancer between SES groups are one potential explanation of cancer disparities that have been extensively reported in the literature. It is evident that high income and high education are associated with awareness about causes of major cancers such as lung and skin, and may allow people to protect themselves and minimize their risks. The data also show that heavier media attention could attenuate the knowledge gaps though moderate publicity or lack of news coverage may actually widen them. Last, the findings in this article suggest that it is necessary to take into account the SES variation within different racial and ethnic groups rather than mask them by treating the groups as one.

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    • "Previous studies have stated that patients with lower income levels tend to rely on subjective information from acquaintances rather than objective data and education when it comes to health and disease [14]. Patients with a lower income level may be more resistant to biopsy owing to costs; however, they are more likely to be influenced into acceptance by the doctor's recommendation [15]. "
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    ABSTRACT: Purpose This study aimed to improve prostate biopsy compliance by analyzing the factors that influence the acceptance of prostate biopsy by patients to whom transrectal ultrasound (TRUS)-guided prostate biopsy is recommended for suspected prostate cancer. Materials and Methods The subjects of this study were 268 patients to whom TRUS-guided prostate biopsy was recommended from January to June 2011 and who completed a questionnaire. Patients who showed a prostate-specific antigen (PSA) increase to more than 4.0 ng/mL or abnormal findings on a digital rectal examination and TRUS were recommended to undergo prostate biopsy. The questionnaire consisted of 9 questions about the subjects' demographic characteristics and 15 questions that assessed their knowledge of prostate disease. Fisher exact probability test was conducted to assess the influence of the demographic characteristics and levels of knowledge of prostate disease on acceptance of prostate biopsy. Results The mean age of the subjects was 66.2 years (range, 43-83 years). Of the cohort, 188 patients (70.7%) agreed to the prostate biopsy and 78 patients (29.3%) refused. In terms of demographic characteristics, the patients' acceptance of prostate biopsy was associated only with education level. Patients with relatively lower education levels had a higher acceptance rate for prostate biopsy (80.0% vs. 65.9%, p=0.018). Other demographic factors, as well as the degree of knowledge of prostate disease, had no significant effect on the acceptance rate. Conclusions The patients' acceptance of prostate biopsy can be influenced by demographic characteristics, especially education level. Therefore, when prostate biopsy is recommended to patients, their demographic characteristics should be taken into consideration.
    Korean journal of urology 07/2014; 55(7):460-4. DOI:10.4111/kju.2014.55.7.460
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    • "Level of education is strongly related to the amount of health information sought and understood, especially in the context of cancer-related issues. Indeed, educational level can influence health-communication behaviors [19] and the acquisition and integration of new information [20]. In this study, a higher level of education was positively associated with HBV vaccine uptake and it was also positively correlated with completing the three-dosage HBV series vaccination. "
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    ABSTRACT: Background Liver cancer is the second most-frequent cause of cancer death in Korea. Hepatitis B virus (HBV) infection is a major cause of liver cancer, and this disease is effectively prevented by HBV vaccination. This study was conducted to investigate factors associated with the lack of HBV vaccine uptake in the general adult male population in Korea. Methods Data of men who participated in a nationwide cross-sectional interview survey were analyzed. A total of 2,174 men 40 years of age and older were interviewed between 2006 and 2008. None of the participants was infected with HBV or was experiencing sequelae of an HBV infection. Results Only half (50.4%) of the men received one or more dose of the three-dose series of HBV vaccinations, and 32.5% received all three doses. Compared with men who had completed the vaccination regimen, non-vaccinated men were more likely to lack supplemental medical insurance for cancer (odds ratio = 0.66, 95% confidence interval: 0.52–0.84), have lower incomes (p-trend = 0.010), and be less educated (p-trend = 0.021). Lower education was also more prevalent in the non-vaccinated group compared with the incompletely vaccinated group. Those who had completed the vaccination regimen were likely to be more educated than those in the incompletely vaccinated group (p-trend = 0.044). The most commonly cited reason for not obtaining the HBV vaccine was lack of knowledge regarding the need for the vaccination. The number of men who cited this reason decreased as a function of education. Conclusions It is important to develop strategic interventions targeted at less-educated men to increase uptake of a complete three-dose series of HBV vaccinations as a primary approach to preventing liver cancer.
    BMC Infectious Diseases 05/2013; 13(1):218. DOI:10.1186/1471-2334-13-218 · 2.61 Impact Factor
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    • "Communicating knowledge and potential actions that could reduce exposure to known risk factors is a critical cancer prevention strategy (Hiatt and Rimer, 1999). Across the cancer control continuum , higher knowledge plays a crucial role in both primary and secondary prevention (Viswanath et al., 2006). It is widely accepted that increasing knowledge is an important step in the causal chain leading to health behaviors. "
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    ABSTRACT: Objective: The aim of this study was to assess the effectiveness of a hepatitis B virus (HBV) educational program in increasing HBV knowledge. Methods: Using a cluster randomized control trial to recruit participants from the community-based organization in the Baltimore-Washington Metropolitan Area; a total of 877 Asian American participants completed a self-administered pretest. HBV knowledge was the outcome measure. The intervention group received a 30-minute educational program. After the educational program, the intervention group completed a post-education survey. Six months after the education, all participants were followed by phone. Results: The intervention group showed significantly higher knowledge scores than the control group at the 6-month follow-up (between-group difference was 1.44 for knowledge of transmission modes and 0.59 for sequelae, p < 0.01). For the intervention group, the increase in knowledge of HBV transmission modes in post-education was much higher than that at the 6-month follow-up (4.18 vs. 2.07), p < 0.01) compared to baseline. Age was also an important factor on the educational effect: Those older than 60 years reported the lowest scores in all three points. Conclusions: Findings suggest that this culturally integrated liver cancer educational program increased HBV knowledge. Differential strategies are needed to target age groups, separately educating those younger and those older.
    Preventive Medicine 11/2012; 56(1). DOI:10.1016/j.ypmed.2012.11.003 · 3.09 Impact Factor
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