Study: Rural Residents Perceive More Cancer-Related Information Overload Than Urban Residents

The study also found conflicting feelings, as participants seemed overwhelmed by too many recommendations while simultaneously perceiving cancer as an unavoidable death sentence.

New research indicates that rural residents tend to hold more fatalistic beliefs and perceive more cancer-related information overload than residents of urban areas, according to a study from the American Association of Cancer Research published in Cancer Epidemiology, Biomarkers & Prevention.

Adults in rural areas have less access to health care infrastructure and experience a disproportionate burden from a variety of disease states, including cancer, compared to residents in more urban areas, according to the study. Clinicians have several barriers to addressing these disparities.

“Addressing this disparity is difficult on multiple levels, but perhaps most challenging is that rural adults often bypass cancer prevention and detection resources when they are made available,” senior author Jakob Jensen, PhD, said in the press release. “Trying to understand the reasons behind this behavior is a pressing task for cancer researchers. Our research hypothesis was that beliefs and attitudes about cancer may be the underlying cause, and that rural adults might be more prone to negative beliefs about cancer, possibly as a way to cope with limited access and resources.

To assess whether cancer beliefs vary between rural and urban adults in the United States, Jensen and his colleagues analyzed the results of a survey conducted between 2016 and 2020 at 12 National Cancer Institute-designated cancer centers. Researchers surveyed 10,362 participants using online and in-person survey instruments, including 3821 rural and 6541 urban individuals.

Participants were asked to rate 4 statements related to prevention-focused cancer fatalism, cancer information overload, and treatment-focused cancer fatalism. The response options included “strongly agree,” “somewhat agree,” “somewhat disagree,” and “strongly disagree.”

The researchers found that rural study participants were significantly more likely to respond that they agreed or strongly agreed with all 4 beliefs, suggesting that rural populations exhibited higher levels of cancer fatalism and cancer information overload. In particular, rural participants were 29% more likely to agree that everything causes cancer, 34% more likely to agree that prevention is not possible, 26% more likely to agree that there are too many different recommendations about cancer prevention, and 21% more likely to agree that cancer is always fatal.

“Our findings are in line with previous research showing that this type of thinking might be a consequence of a wider cultural setup that fosters self-reliance and coping beliefs in response to stress and lack of resources,” Jensen said in the press release. “This is known as the psychological stress and coping theory. The findings of our study are consistent with this logic as populations with fewer resources (in this case, rural adults) are more likely to reduce (fatalism) or revise (overload) the situation.”

The study also found conflicting feelings, as participants seemed overwhelmed by too many recommendations while simultaneously perceiving cancer as a death sentence that is unavoidable.

“New strategies to effectively integrate multiple recommendations at once would be helpful,” Jensen said in the press release. “Alternatively, the focus should be placed on one recommendation at a time.”

The surveys also gathered data on a range of socio-demographic and behavioral variables, including age, gender, race and ethnicity, income, education, employment status, primary source of health care coverage, marital status, cost barriers to medical care, and smoking status. In particular, they found that lower education was associated with fatalism and information overload, which could reflect differences in scientific literacy.

Based on all of the observations, Jensen said empathy could be the starting point for an effective communication approach. By acknowledging their feelings about a cancer diagnosis or prevention efforts, clinicians could better engage rural populations.


Rural Residents Tend to Hold Fatalistic Beliefs and Perceive More Cancer-Related Information Overload Than Urban Residents. News release. EurekAlert; January 28, 2022. Accessed January 28, 2022.