Why Certain Cancer Prevention Messages are Hard to Follow

There are certain things we can do ourselves that can help prevent certain cancers— such as choosing not to smoke, eating healthy and exercising and getting preventative screenings. Armed with facts like these at our fingertips, why do we sometimes choose not to partake in healthy lifestyle behaviors? 

Mark Landau, Ph.D., associate professor of Psychology at The University of Kansas and member of the Cancer Control & Population Health Research Program at The University of Kansas Cancer Center, is looking at how we can enhance health messages to encourage cancer-preventative behaviors. His method involves using metaphors to  help people make sense of cancer risk and prevention – concepts that might otherwise seem abstract and difficult to grasp. 

“If someone tells you about their recovery from a cold by saying ‘I’ve come a long way, but I’m not out of the woods yet,’ she is describing the abstract idea of recovery as through it were a kind of physical journey along a path leading to health,” explains Dr. Landau. “That observation led us to propose that using metaphors to frame cancer risks and treatments might be effective at motivating people to adopt lifestyle behaviors that reduce their risk of cancer, like applying sun-safe products.”

So how does something commonly used in literature help change people’s perceptions on cancer? Previous research has shown that people are more motivated by messages that both increase their concern that cancer is an imminent threat and convince them the recommended behavior is effective. Dr. Landau and his team believe that current cancer risk and prevention messages might be too abstract to elicit these reactions. Because metaphors provide concrete imagery, they have the potential to help people grasp what is considered a risk and what they can do to protect themselves. 

One ongoing study testing this idea focuses on people’s understanding of skin cancer. A health message designed to encourage young adults to apply sunscreen may not be persuasive for a couple of reasons. 

First, the audience may see the risk of sun cancer as too far removed from the realities of their everyday life, according to Dr. Landau. . As a result, they don’t feel concerned enough to take action in the present. Second, he believes the message leaves them without a compelling mental image of how sunscreen might protect them. 

“A metaphor can be used to compare that risk to a more concrete, easily-visualized hazard,” explained Dr. Landau. “It could compare the sun’s ultraviolet rays to a hostile army intent on attacking one’s body. This might elicit the concern necessary to energize prevention behavior.” 

Preliminary findings support this possibility. A brochure designed to use metaphoric expressions and imagery to compare the sun to a violent enemy was more effective at increasing intentions to apply sunscreen than a parallel message that did not use metaphors. This effect was particularly strong if the message also framed sunscreen metaphorically as a type of “armor” that protects one’s skin against the sun’s “punches,” suggesting that metaphors also help people to understand how a recommended treatment behavior works. 

Dr. Landau’s work, alongside colleagues Jamie Arndt, professor of psychology at The University of Missouri, and Linda Cameron, professor of psychology at The University of California-Merced, looks at how metaphors affect prevention behaviors in a series of experimental studies. They will see how the metaphors interact with emotional thought processes, as well as who in particular would benefit most from metaphoric messages. 

Finally, they will test both short and long-term behavior changes that result from the different types of messaging. 

Dr. Landau is focusing on skin, lung and colon cancer prevention messaging because, he says, “research suggests that these cancers can be prevented by changing high-risk behaviors and reducing exposure to environmental risk factors. That gives us more room to develop interventions that persuade people to engage in healthier lifestyles.”


Funding sources

Relevant publications

  • Keefer, L. A., Landau, M. J., Sullivan, D., & Rothschild, Z. K. (2014). Embodied metaphor and abstract problem solving: Testing a metaphoric fit hypothesis in the health domain. Journal of Experimental Social Psychology, 55, 12-20.
  • Landau, M. E., Robinson, M. D., & Meier, B. P. (2014). The power of metaphor: Examining its influence on social life. American Psychological Association.
  • Landau, M. J., Keefer, L. A., & Rothschild, Z. K. (2014). Epistemic motives moderate the effect of metaphoric framing on attitudes. Journal of Experimental Social Psychology, 53, 125-138.

Cancer Prevention Campaigns

Cancer organizations of all kinds have tried various types of messaging to get cancer prevention messages across. Here are a few notable campaigns:
  • Put Vaccination on Your Back-to-School List
  • The human papillomavirus (HPV) vaccine is given in a series of shots, ideally around ages 11 or 12. It is given at that age so children can develop protection against the various types of HPV long before they are actually exposed to the disease. Data has shown the vaccines have helped reduce the HPV rates by half in teenage girls. (Centers for Disease Control and Prevention)
  • Jeff the Diseased Lung
  • John Oliver and his HBO staff came up with the mascot Jeff the Diseased Lung when doing an extended segment on how tobacco companies keep attracting customers around the world. Jeff was the anti-smoking version of the Marlboro Man, one of the tobacco industry’s biggest ad campaigns. Meant to be a funny punchline on a late-night show, The Campaign for Tobacco-Free Kids used Oliver’s mascot to organize a flash mob in Times Square to raise awareness on smoking and lung cancer. (The Campaign for Tobacco-Free Kids).
  • Slip! Slop! Slap! and Wrap
  • This catchphrase seeks to remind people to: Slip on a shirt, slop on sunscreen, slap on a hat and wrap on sunglasses. (American Cancer Society)