Abstract: Demographic and Psychosocial Correlates of Family Cancer History Communication among U.S. Adults: Findings from the 2018 HINTS

◆ Diane B. Francis, University of Kentucky
◆ Marc T. Kiviniemi, University of Kentucky

Many Americans are susceptible to cancers that run in their families, and a family history of cancer increases an individual’s risk of developing cancer.1 Awareness that family history is associated with cancer outcomes remains low.2-3 Lack of discussions within family networks contributes to low awareness,2-3 yet predictors of family cancer history communication are not well understood. The study examined demographic and psychosocial correlates of family cancer history communication.

Data from the 2018 Health Information National Trends Survey were used to describe awareness of family cancer history (1=No knowledge; 5=Very well); confidence in completing family cancer history information (1=Not at all confident; 5=Completely confident); and discussions about family cancer history (1=Ye; 0=No) among 3,504 adults. HINTS 2018 was the first to assess family cancer history communication among a national sample of U.S. adults. Weighted multivariable linear and logistic regressions determined factors associated with study outcomes.

A third of the U.S. population (33.40%) said they were very well aware of their family's cancer history, while 6% said they did not know their family's history at all. Another 30% said they knew some (22.82%) or a little (7.35%) of their family's cancer history. One-fourth (25.13%) said they were completely confident that they could complete a summary of their family cancer history on a medical form; more than 20% combined said they were not at all (11.63%) or a little (9.73%) confident. While more than three-fourths of Americans said they had discussed their family's cancer history (most often with their mother or sister), 22% said they had not had any discussions about such information.

In multivariate linear regression analyses being female and having some college or more were positively associated with awareness of and confidence in completing information about family cancer history. Being older was positively associated with confidence. While few racial differences emerged, Asian Americans significantly less aware and less confident. Having ever looked up information about cancer was also associated with confidence.

The logistic regression analysis also showed that females (OR: 1.74, p < .01) and those with some college (OR: 2.39, p < .05) or college graduate (OR: 2.90, p < .05) had higher odds of discussing family cancer history. Black/African Americans (OR: .49, p < .05) and foreign-born Americans (OR: .51, p < .05) had lower odds of discussing family cancer history. People with a family member who had ever had cancer had .31 lower odds while people who ever looked up information about cancer had 2.10 higher odds of discussions. Awareness (OR: 1.72, p < .001) and confidence (OR: 1.41, p < .001) were also associated with discussions. Psychosocial variables (i.e., beliefs about cancer) were not associated with family cancer history discussions.

This is the first study, to our knowledge, to investigate the predictors of family cancer history communication nationally. The findings indicate disparities in communication behaviors. Men, racial/ethnic minorities, and those with less education were less engaged with their family's cancer history information and discussions. The study has implications for cancer communication and communication inequalities.