Fatalism and educational disparities in beliefs about the curability of advanced cancer.
Paul R Duberstein, Michael Chen, Benjamin P Chapman and 4 others
PMID 28716485WHAT IT FOUND
Most (81.7%) patients with incurable advanced cancer believed it could be cured.
Patients who had not completed high school were more likely to believe this, but adding fatalism weakened the education link.
Key findings
0181.7% of patients believed their incurable advanced cancer could be cured.
02Patients who did not complete high school had a 155% increase in the odds of believing they could be cured compared with those with more than a college education (OR=2.55; 95% CI:1.09–5.96).
03When fatalism was included, the association between education and believing cure was possible was attenuated by about 39% and became nonsignificant (OR=1.95; 95% CI:0.79–4.85).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional and secondary, so it cannot show that education or fatalism causes beliefs about curability. The original CanCORS study was not designed a priori to examine education, fatalism, and beliefs about cure. Findings may not apply to other cancers or to patients who declined cancer treatment. Religious practice and spirituality were not measured, and the fatalism scale was generic rather than cancer-specific. The belief that incurable cancer could be cured was common across the sample, so the education finding does not mean only patients with less education misunderstood their prognosis.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not conclude that only patients who did not complete high school misunderstand curability. Most (81.7%) of the sample believed their incurable cancer could be cured, and fewer than 20% knew that cure was not a realistic expectation.