title: Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England.
abstract: Communication of cancer information is an important element of cancer control, but cancer fear may lead to information avoidance, especially when coping is low. We examined the association between cancer fear and cancer information avoidance, and tested whether this was exacerbated by psychosocial stress.
  
  
  
  Cross-sectional survey of 1258 population-based adults (58-70 years) in England.
  
  
  
  Cancer fear (intensity and frequency), perceived psychosocial stress and cancer information avoidance. Control variables were age, gender, ethnicity, marital status and education.
  
  
  
  A quarter (24%) of respondents avoided cancer information. Ordinal logistic regression analyses showed main effects of psychosocial stress (OR = 1.17, 95% CI 1.07-1.29) and cancer fear: cancer information avoidance was lowest in those with no cancer fear (13%), followed by those with moderate (24%; OR = 2.15, 95% CI: 1.49-3.12), and high cancer fear (35%; OR = 3.90, 95% CI: 2.65-5.73). In the adjusted model, the interaction between cancer fear and stress was significant (OR = 1.14, 95% CI 1.004-1.29, p < .05): 40% of those with high fear/high stress avoided cancer information compared with 29% with high fear/low stress.
  
  
  
  Cancer fear and psychosocial stress interact to produce disengagement with cancer-related information, highlighting the importance of affective processes to cancer control efforts.
authors.affiliation: a Research Department of Behavioural Science and Health , University College London , London , UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Vrinten
authors.affiliation: a Research Department of Behavioural Science and Health , University College London , London , UK.
authors.forename: David
authors.initials: D
authors.lastname: Boniface
authors.affiliation: a Research Department of Behavioural Science and Health , University College London , London , UK.
authors.forename: Siu Hing
authors.initials: SH
authors.lastname: Lo
authors.affiliation: a Research Department of Behavioural Science and Health , University College London , London , UK.|b Harvard Center for Population and Development Studies , Harvard University , Cambridge , MA , USA.
authors.forename: Lindsay C
authors.initials: LC
authors.lastname: Kobayashi
authors.affiliation: a Research Department of Behavioural Science and Health , University College London , London , UK.
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
authors.affiliation: a Research Department of Behavioural Science and Health , University College London , London , UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Waller
mesh_terms: D000368:Aged; D001362:Avoidance Learning; D054626:Consumer Health Information / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004739:England; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*
keywords: avoidance; cancer; fear; health communication; psychosocial stress; worry