Most individuals who have not been affected by childhood cancer mistakenly believe that childhood cancer is caused by genetic or environmental factors, not simply bad luck, according to a new study by medical researchers at UNSW.

The team of researchers has highlighted community beliefs about what causes cancer in children, an area which remains understudied.

“Few childhood cancers are attributed to genetics or environmental factors, so when children are diagnosed with cancer, families often wonder ‘why me/why us‘?” said lead author Janine Vetsch, postdoctoral research candidate from UNSW Sydney in Australia.

The attributed cause of cancer in childhood cancer patients and their primary caregivers differ to those of adult-onset cancers. Most childhood cancer patients are diagnosed at a young age (often between 0 and 5 years). Children are rarely exposed to carcinogens or long-term environmental factors, or engaging in risky health behaviours.

The team examined the beliefs of more than 600 participants — parents and childhood cancer survivors — about the causes of childhood cancer, and compared them with beliefs of 510 members of the general population.

Understanding the cause of their cancer is important for many cancer patients. Childhood cancer survivors’/survivors’ parents’ beliefs about cancer etiology are understudied. We aimed to assess survivors’/parents’ beliefs about what causes childhood cancer, compared with beliefs in the community. We also investigated the influence of clinical and socio-demographic characteristics on the participants’ beliefs about cancer etiology.

Findings

The findings, which were published in Acta Oncologica a week ago, revealed that more than seven out of 10 childhood cancer survivors and survivors’ parents believed that chance or bad luck caused the cancer. 

A strength of this study is the use of mixed-methods data which has the advantage of overcoming the weakness of each methodology. Another strength is the large sample size and the population-based approach, including both survivors and parents. A further strength is the use of a community comparison group.

Even though only a few studies have found associations between childhood cancer etiology and environmental factors, results showed that one-quarter of the survivor group attributed environmental factors to their (child’s) cancer. Consistent with large epidemiological studies, survivors and survivors’ parents attributed environmental factors more often if diagnosed with leukemia.

Previous studies indicated that when cancer patients make external attributions (i.e., believe the cancer was not caused by their own actions/behavior such as genetics or bad luck), they may cope better with their treatment and experience fewer negative feelings (e.g., self-blame, long-term guilt)

Conclusions

Survivors and survivors’ parents most commonly endorsed ‘bad luck/chance’. Community participants mainly attributed environmental factors and genetics. These results may indicate that HCPs are helping families understand that the causes are often unknown or related to chance/bad luck and there was nothing parents could have done to prevent the cancer in most cases.

In uninvariable regression, we also found that religious participants were less likely to attribute bad luck/chance as a cause of childhood cancer potentially indicating a less fatalistic approach. However, further research is needed to understand different religious and cultural factors associated with causal attributions. Highly educated participants and participants with a higher income were more likely to associate environmental factors to cancer etiology suggesting that socio-economic factors may influence health perceptions such as identifying health risks (i.e., carcinogens) and possibly adapting future health behaviors

It looks like healthcare professionals are successfully helping most families arrive at that view,” said Vetsch. Such views could lead to stigma. Hence, it is important to increase community knowledge of childhood cancer causes in general. 

There is a need to encourage doctors to talk about the causes with affected families to address unhelpful misconceptions,” Vetsch suggested.

More Awareness of Childhood Cancer Needed

Important global initiatives such as the Childhood Cancer Awareness Month have been started to raise awareness and funds through global charities and social media platforms. However, the findings highlight the importance to further increase the awareness of childhood cancer among the general community to avoid stigma and self-blame in affected families.

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