God and agency in the era of molecular medicine: Religious beliefs predict sun-protection behaviors following melanoma genetic test reporting

Little is known about how religious beliefs are related to the understanding and management of genetic test results in cancer-prone families. Twenty-five adult US members of The Church of Jesus Christ of Latter-day Saints (LDS) who had received CDKN2A/p16 genetic test results for familial melanoma were asked 1 year later to describe any religious or spiritual beliefs that were important to their understanding of their genetic test results and to complete concurrent assessments of perceived control, cancer fatalism, and adherence to sun-protection recommendations. Overall, 88% of participants listed one or more religious themes as important to their understanding and/or management of genetic test results, with no differences between carriers and non-carriers. All religious themes were significant predictors of at least one sun-protection or UV risk behavior in the past 6 months. Personal agency/responsibility for health (listed by 60%) predicted greater perceived control over melanoma development among participants with a history of melanoma and decreased reports of being tanned in the past 6 months. Belief that cancer was God's will (56%) predicted greater beliefs about the lethality of melanoma, but was unrelated to perceived control or other fatalistic beliefs. Forty percent of respondents reported emotional benefits of religious faith in managing their own or a family member's cancer risk. Twenty-four percent indicated that scientific and medical advances were gifts from God. Participants who indicated that their religious beliefs were unrelated to their understanding of genetic test results (16%) reported fewer sun-protection behaviors and much more frequent sunburns and tans. These results suggest that even in a sample with strong endorsement of cancer as God's will, religious beliefs are associated with greater perceived control over melanoma development and greater adherence to prevention recommendations in high-risk patients. Implications for understanding the relation between religious beliefs and the management of elevated cancer risk are discussed.