Negative messages keep blacks from cancer tests

NEW YORK (Reuters Health) - Cancer news stories and public service announcements that call attention to the fact that African Americans are often diagnosed with cancer at later stages and have lower survival rates than whites may discourage African Americans from getting screened for cancer, new research shows.

“We have typically assumed that one of the best ways to motivate individuals is to point out disparities in health, but we may be having negative unintended consequences,” Dr. Robert Nicholson of the St. Louis University School of Public Health, noted in a statement.

“Instead of motivating people who would be less likely to get these services in the first place, we may be driving them away,” Nicholson warned.

He and colleagues asked 300 African-American adults to read one of four very different articles about colon cancer and then answer questions about their likelihood of going for screening.

The participants were recruited locally, were an average of 54 years old, most were women and nearly all had completed high school. The average score on a medical mistrust scale was moderate.

The first article emphasized that colon cancer was an important problem for African Americans. The second emphasized that outcomes for blacks with colon cancer were worse than for whites. The third article explained that while outcomes for African Americans were improving, the improvement was less than that seen among whites. The fourth article discussed how outcomes for blacks with colon cancer were improving over time.

The investigators found that African Americans who read the article that said outcomes for blacks were improving over time were more likely to have a positive emotional reaction, being more likely to want to participate in cancer screening, than if they read any of the other three articles.

The articles most likely to generate a negative emotional reaction, and reduce the likelihood of wanting to be screened, were the ones that emphasized the racial disparities.

The results of the study, published in the journal Cancer Epidemiology, Biomarkers & Prevention, suggest that constantly emphasizing racial disparities in cancer may undermine prevention and control efforts by making minorities less apt to go for screening, Nicholson and colleagues say.

Cancer communication messages that include race-specific data for African Americans will be better received and have greater impact if they emphasize the progress African Americans are making, they conclude.

SOURCE: Cancer Epidemiology, Biomarkers and Prevention, November 2008.

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