Cancer survivors undergoing treatment more likely to believe COVID-19 misinformation
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Patients undergoing cancer treatment demonstrated a higher likelihood of believing misinformation related to COVID-19 than those without a history of cancer, according to a study published in Patient Education and Counseling.
“COVID-19 misinformation is a significant public health concern, and more vulnerable groups may be at increased risk of believing such types of misinformation —something their health care providers should be aware of and possibly address in relation to patients’ concerns about the pandemic and how it relates to their treatment," Jeanine P.D. Guidry, PhD, assistant professor at Robertson School of Media and Culture and director of the media and health lab at Virginia Commonwealth University, told Healio.
Background and methodology
Guidry and colleagues set out to determine whether cancer survivors undergoing treatment were more or less likely to endorse COVID-19-related misinformation than their counterparts no longer in treatment and those without a cancer history.
The analysis included self-reported data of 897 adults who responded to a Qualtrics online survey conducted June 1-15, 2020 — 32% currently in treatment (n= 287; median age, 48.17 years; 53% women; 80.1% white), 33.6% either not currently in or finished with treatment (n = 301; median age, 56.43 years; 51.8% women; 87.4% white) and 34.4% with no cancer history (n = 309; median age, 44.3 years; 50.2% women; 34% white).
“We realized early in the pandemic that [patients with cancer] currently in treatment are in an especially vulnerable position during the pandemic — the pandemic adds stress to what is likely an already stressful environment,” Guidry said. “We wanted to see if this group would perhaps be more susceptible to believing COVID-19 misinformation, which would add a potentially complicating factor to an already difficult situation.”
Key findings
Results showed survivors no longer in treatment endorsed COVID-19 misinformation at a significantly lower level (B = 0.15; P < .001) than individuals without cancer. However, participants in active cancer treatment endorsed misinformation at a significantly higher level (B = 0.1; P = .019) than those without cancer.
Education, race or perceived stress from COVID-19 had no significant effect on endorsement of COVID-19 misinformation. Men had a higher likelihood of endorsing COVID-19 misinformation (B = 0.13; P < .001), as did older vs. younger survey participants (B = 0.4; P < .001).
“Unfortunately, we were not as surprised as we might have been (with the results),” Guidry told Healio. “In an earlier study of ours, when compared with parents of children with no cancer history, we found that parents of children in cancer treatment were more likely to endorse COVID-19 misinformation, as well.
“Our primary concern,” Guidry continued, “is that these are already more vulnerable groups that now also respond in a specific way to COVID-19 related misinformation, which in turn may have effects on their cancer treatment outcomes or their experiences with COVID-19.”
Implications
Oncologists and other providers working with patients in treatment for cancer should be particularly mindful that this group may be more likely to believe misinformation, according to the researchers. They also recommended strategic communications catered to individuals at high risk for COVID-19 complications due to underlying comorbidities.
Because patients undergoing treatment are particularly vulnerable to misinformation, the cancer care community must address patients’ concerns on how the pandemic relates to their course of treatment, the researchers wrote.
“Considering the impact that misinformation has had and is having on the COVID-19 pandemic, the more we understand about how and why specific groups may be more susceptible to the endorsement of this type of misinformation, the better,” Guidry said.
Guidry hopes to pursue a more qualitatively focused follow-up study to better understand why these patients are more vulnerable.
“In addition, we would like to see more research on how we can best address this type of misinformation in this specific population, and if the higher endorsement of COVID-19 misinformation is associated with any actions that could affect treatments or outcomes [of patients with cancer],” Guidry said.
For more information:
Jeanine P.D. Guidry, PhD, can be reached at Virginia Commonwealth University, College of Humanities and Sciences, Richard T. Robertson School of Media and Culture, 901 W. Main St., Room 2216, Box 842034, Richmond, VA 23284; email: guidryjd@vcu.edu.
Perspective
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The survey by Guidry and colleagues was conducted during the first COVID-19 surge, when clinicians and scientists were still learning about the virus and when public health risk mitigation was evolving, based on the latest information available. During this time of uncertainty, the internet ballooned with information that was not based on data (misinformation) and being used for purposes other than public health, such as fame, financial gain or to sow discord (ie, disinformation).
The question of how this impacts people with cancer is relevant; we know people turn to the internet for health-related information and cancer is among the top health issues that prompt these searches. It is, therefore, very likely that people touched by cancer would also be interested in learning more about COVID-19, or at least encounter information on the subject during their internet searches. It may seem plausible that people who have greater access to or actively seek out information on social media are more prone to getting absorbed in the spiral of misinformation.
The data in this study have direct implications on the patient-physician relationship in oncology. Perhaps most important, oncology professionals should not assume that people who trust the role of anticancer treatment automatically trust the public health response to COVID-19, whether that be the mitigation strategies of masks or the recommendation to pursue COVID-19 vaccination. Indeed, this study challenges that assumption directly. Clinicians, therefore, must query patients about their attitudes regarding COVID-19, as well as their uptake of vaccines. When faced with the person who believes misinformation is true, we must engage them to better understand the basis of their beliefs (or misbeliefs) and point them toward accurate and reliable sources. The challenge is to do so without weakening the trust in a patient-physician relationship.
Several points are worth noting. As with any internet-based study, the research team relied on self-report without validation, raising the issue of reliability, which remains an inherent issue with online research. In addition, the survey group was not racially diverse, which speaks toward generalizability.
We also do not know how lived experience during the COVID-19 pandemic weighed on responses. For example, one could presume that respondents who had a personal history of COVID-19 may answer differently than those without one.
Finally, we have no information on how the volunteers were selected — through online patient communities, online advertisement or other means — which means we cannot calculate the response rate.
Still, this provocative finding should spur further research into the penetration of COVID-19 misinformation within cancer communities and, perhaps more importantly, evidence-based tactics to help address and mitigate its spread.
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