Mar 15 2013

Confusion Reigns: Cutting Through the Overload of Information on Cancer Prevention

Jeff Niederdeppe, PhD, is an assistant professor of communication at Cornell University and an alumnus of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of Wisconsin.


For the past 10 years or so, my colleagues and I have been studying how Americans make sense of public information about the causes of cancer and ways to prevent it. This has brought both good and bad news.

First the bad (and perhaps not surprising) news: many Americans are overloaded with information about cancer prevention and feel powerless about what they can do to prevent it. According to national surveys, one in four say there’s not much a person can do to reduce their risk of cancer, half feel that almost everything causes cancer, and three in four think there are too many recommendations to know which ones to follow. People who hold these beliefs are less likely than those who do not to engage in behaviors that we know reduce their risk of cancer – avoiding smoking and sunburn, eating a diet rich with fruits and vegetables, exercising regularly, and maintaining a healthy weight. These beliefs thus appear to have troubling consequences for broader efforts to reduce the rate of cancer in the U.S. through primary prevention.

In many ways, these feelings are understandable – it IS confusing. Cancer is not a single disease, but hundreds of them affecting different organs in the body, with different causes, different tests to screen for them, different treatments, and different prognoses. By some estimates, half of all cancer cases have an unknown cause. Cancer research moves slowly and incrementally, but increasingly publicly – one study might suggest that coffee causes cancer, while another points to its preventive potential. Science requires a back-and-forth between scientists as they sort out what findings hold up and which ones prove only preliminary. This process is absolutely necessary, but can offer a false sense of hope or opportunity if appropriate caveats aren’t offered in early stages of this work, or if preliminary results are publicized widely through the media.

We’ve learned a great deal about where these beliefs come from. First and foremost, they are socially patterned – fatalistic and overloaded beliefs are most prevalent among those with low levels of formal education. This may reflect the reality of cancer, which has a disproportionate burden on those with lower socioeconomic status, or the challenge in making sense of cancer-related information. Second, we consistently find that those who get their news from local TV are more likely to feel fatalistic and overloaded about cancer’s causes and prevention. We don’t find the same pattern for newspapers, national TV, or radio news. Local TV appears to cover cancer in ways that are systematically different than these channels – local TV stories are shorter, focus more frequently on new and emerging cancer causes (over treatment, prevalence, or prevention), and rarely emphasize what CAN be done to reduce the risk of cancer.

Now the good news. Americans are increasingly turning to the Internet for health-related information, and my colleagues Chul-joo Lee (University of Illinois at Urbana-Champaign) and Derek Freres (University of Pennsylvania) and I have found that the use of the Internet for health information is linked to a decrease in overloaded and fatalistic beliefs over time. This relationship appears to be driven by those with less formal education, suggesting that the Internet holds potential to reduce disparities in cancer-related beliefs by socioeconomic status. At first glance, this seems counterintuitive – it is possible to find false information on the Web and at times difficult to discern credible sources from non-credible ones. At the same time, the networked structure of the Internet is conducive to health-related information seeking – if one site does not offer sufficient information, a user can fairly easily find another site that does. And there are many credible sources that are easily accessible through Google or other web search engines – for example, the National Cancer Institute and American Cancer Society offer prevention information that is well-organized, up-to-date, and accurate.

This study is, of course, just a starting point – we don’t know enough about how people navigate health information on the Web, or what role blogs or social media may play in this process. And there are still notable segments of the U.S. population without broadband Web access, for whom use of the Internet of health information is not an easy option. We’re continuing to work on these complex and challenging issues.

We’ve also been developing strategies for scientists, journalists, and health communicators to convey new cancer research without increasing a sense of overload and confusion. Acknowledging the limitations of new research studies appears to be important, as does emphasizing what we DO know about cancer prevention when talking about what we do not. But tried and true information about cancer prevention is not always newsworthy, and is thus difficult to place on the public or news agenda. Public health advocates have their work cut out for them in their laudable efforts to reduce rates of cancer in the U.S. through prevention.

Read about one of Niederdeppe’s earlier studies on how local television affects fatalistic beliefs regarding cancer prevention.

Research Papers Referenced in this Post:

Niederdeppe, J., & Gurmankin Levy, A. G. (2007). Fatalistic beliefs about cancer prevention and three prevention behaviors. Cancer Epidemiology, Biomarkers, and Prevention, 16, 998-1003.

Niederdeppe, J., Fowler, E.F., Goldstein, K, & Pribble, J. (2010). Does local television news coverage cultivate fatalistic beliefs about cancer prevention? Journal of Communication, 60(2), 230-253.

Lee, C. J. & Niederdeppe, J. (2011). Genre-specific cultivation effects: Lagged associations between overall TV viewing, local TV news viewing, and fatalistic beliefs about cancer prevention. Communication Research, 38, 731-753.

Lee, C. J., Niederdeppe, J., & Freres, D. (2012). Socioeconomic disparities in fatalistic beliefs about cancer prevention and the internet. Journal of Communication, 62(6), 972-990.


Tags: Cancer, Research, Patients, Human Capital, Health & Society Scholars, Voices from the Field, Research & Analysis