The Effects of Cancer Fear and Ruminative Thinking Styles on Attitudes Toward Cancer Screening Among Cancer Caregivers.

Abstract

Despite being exposed to a high risk of cancer and a substantial psychological burden, cancer caregivers often neglect their own health check-ups and cancer screening behaviors. This study aimed to examine the effects of ruminative thinking styles and cancer fear on attitudes toward cancer screening among cancer caregivers. This cross-sectional descriptive study was conducted between August 2025 and January 2026 with 446 primary caregivers of patients receiving outpatient treatment in the medical and radiation oncology departments of a training and research hospital located in eastern Turkey. Data were collected through face‒to-face interviews via a sociodemographic questionnaire, the Cancer Fear Scale, the Ruminative Thought Style Scale, and the short form of the Attitudes Toward Cancer Screening Scale. The results revealed a moderate, positive, and statistically significant association between fear of cancer and ruminative thoughts (r = 0.543, p < 0.001). Hierarchical regression analysis showed that fear of cancer explained 19.3% of the variance in attitudes toward cancer screening (R² = 0.193) and that when ruminative thought was included, the explained variance increased to 22.4% (R² = 0.224). Both variables were identified as significant and negative predictors of attitudes toward cancer screening (p < 0.001). This indicated that ruminative thought partially mediated the relationship between fear of cancer and attitudes toward cancer screening (indirect effect = -0.106, 95% bootstrap CI [- 0.171, -0.056]). These results show that fear of cancer and ruminative thoughts constitute significant psychological barriers that negatively influence the attitudes of individuals providing care to patients with cancer. This underscores the importance for care providers to develop interventions targeting these psychological barriers.