Elementary school-age children's developmental understanding of the causesof cancer

This study examines children's conceptual understanding and factual knowled ge of the causes of cancer. Using a standardized, developmentally based, se mistructured interview (ASK [AIDS (acquired immunodeficiency syndrome) Surv ey for Kids]), 784 children (43% black, 38% white, and 18% Hispanic; 48% fe male) in kindergarten through sixth grade attending six public elementary/m iddle schools in New Haven, Connecticut, were asked open-ended questions ab out the causes of cancer and, for comparison, the causes of colds and AIDS. Responses were scored for level of conceptual understanding and coded for factual content and factual accuracy. The level of conceptual understanding for causality of cancer increased consistently as grade level increased. W hen comparisons were made among the illnesses, children's level of conceptu al understanding was significantly lower for the causes of cancer than for the causes of colds (p < .0001), but not significantly different from that of AIDS. Although the single most frequent cause of cancer mentioned was ci garettes/smoking (24%), more than one in five students stated that casual c ontact or contagion was a cause of cancer. More children cited casual conta ct/contagion than cited the following factually accurate or logically contr ibutory causes combined: poor diet, air/water pollution or overexposure to sun, alcohol, and old age. Slightly more than one half of students in kinde rgarten through sixth grade worried about getting cancer, and the vast majo rity (80%) knew that cancer could be fatal. Children have a less sophistica ted conceptual understanding of cancer than of colds and a very limited fac tual knowledge base for cancer, and thus they have the capacity to increase both their understanding and knowledge. These results have implications fo r the creation of developmentally appropriate cancer prevention curricula f or elementary school-age children.