Could a fatalistic attitude toward cervical cancer serve as a barrier to prevention of the disease? A recent study conducted by University of Kentucky researchers in the Rural Cancer Prevention Center suggests a link between fatalistic beliefs and completion of the human papillomavirus (HPV) vaccine series among a sample of young Appalachian Kentucky women.
The HPV vaccination series consists of three shots and helps prevent HPV infection and cervical cancer. Previous studies have shown that cost, lack of transportation, cultural views, and lack of knowledge about cervical cancer prevention as well as limited support from health care providers has prevented Appalachian women from getting or completing HPV vaccination in the past.
The concept of fatalism as it relates to health asserts that individuals perceive themselves to have limited control over what happens to their health and that health outcomes may be determined by fate. Previous research has found that some Appalachian women have reported fatalistic beliefs regarding their health, including the perception that being diagnosed with or preventing cancer is out of their control.
Published in The Journal of Rural Health, the study involved research nurses administering the first dose of the HPV vaccine series free of charge to Appalachian Kentucky women aged 18-26. The young women were then surveyed about their beliefs regarding cancer and followed for nine months after receiving the first dose to determine vaccination series completion; nearly 350 women participated in the study.
The study found that women who held fatalistic beliefs about their perceived lack of control over their health and cervical cancer had a significantly lower likelihood of completing the HPV vaccination series.
According to the Centers for Disease Control and Prevention, HPV is the most common sexually transmitted infection in the United States, affecting more than 79 million people. Nationally, Kentucky has some of the highest rates of HPV-related cancers; according to the Kentucky Cancer Registry, these elevated cancer rates are primarily attributable to cancer disparities observed in the 54-county Appalachian region of the state.
Almost all cervical cancers are caused by HPV, and several other cancers are linked to the virus as well, including head and neck, anal, penile, vulvar, and vaginal malignancies. Completing the vaccination series is the best way for young women (and men) to protect themselves against HPV infection and HPV-related cancers.
Personal beliefs like fatalism can serve as barrier to preventive health care measures such as HPV vaccination. Findings from the study indicate that fatalistic beliefs should be addressed in a culturally sensitive manner through education and tailored communication messaging. Such efforts may help increase HPV vaccination rates and decrease cervical cancer rates in Appalachian Kentucky.
"Results from this study may encourage health care providers to proactively assess and address young women's personal health beliefs and develop a strategy for helping them complete the HPV vaccination series," Robin Vanderpool, associate professor in UK's Department of Health Behavior and deputy director of the Rural Cancer Prevention Center, said.
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