Thesis
Cancer knowledge, exposure beliefs, and prevention behaviors in Iowa's agricultural communities
University of Iowa
Master of Science (MS), University of Iowa
Spring 2026
DOI: 10.25820/etd.008414
Abstract
According to the Iowa Cancer Registry, Iowa has the second highest and fastest growing cancer incidence rate in the United States, raising public concern about the potential role of agricultural exposures in the state’s increasing cancer rates. This issue is particularly relevant for agricultural communities, which face barriers to accessing healthcare compounded by unique environmental and occupational exposures; however, little is known about what these communities know and believe about cancer. National and international agricultural cohort studies supported by the National Institutes of Health show that overall cancer incidence is lower among farmers than in the general population, but this group experiences higher rates of certain cancers, including blood, skin, thyroid, prostate, and lip. Because cancer results from a combination of genetic, behavioral, and environmental factors, it is important to understand the knowledge, perceptions, and behaviors underlying exposures in everyday environments.
This study aimed to understand cancer-related knowledge, beliefs, information sources, and risk reduction behaviors among people living and working in agricultural communities in Iowa. An online survey assessed perceptions of cancer risk factors, concerns related to occupational exposures, sources of cancer information, and engagement in cancer risk reduction behaviors. The survey was distributed throughout Iowa via email lists and flyers through cancer control, agricultural extension, and rural health organizations. Recruitment targeted owner-operators, agricultural workers, family members living on agricultural operations, service contractors, and nearby residents. A total of 228 responses were included in the analysis.
The findings revealed a substantial understanding of fundamental concepts related to cancer development, such as long latency and multifactorial causes. There was a high awareness of many established cancer risk factors, including radon, tobacco, diet, genetics, pesticides, water contaminants, and asbestos, but awareness was lower for other common carcinogens in agriculture, such as diesel exhaust and wood dust. Many participants expressed concern about exposures in their living and working environments alongside lower confidence in their ability to reduce risks at work. Participants felt confident in finding cancer information and most often relied on and trusted healthcare providers, health organizations, and government agencies. Most respondents recognized cancer risk reduction behaviors in agricultural settings, such as sun protection, personal protective equipment (PPE) use, private well water testing, radon testing, and proper handling of contaminated clothing, but reported low levels of practice.
There is a need for cancer prevention and control strategies that address agriculture-specific occupational and environmental exposures, such as diesel exhaust and chemicals, as well as Iowa-specific exposures like radon and arsenic. The relationship between environmental exposures and cancer risk in agricultural settings remains an area where clear messaging and practical guidance could reduce confusion, correct misconceptions, and support meaningful behavioral and environmental change while acknowledging community concerns. People living and working in agricultural settings face cumulative risks from both workplace and household environments, so it is necessary to develop interventions and resources that integrate agricultural safety and health practices with rural health promotion.
Details
- Title: Subtitle
- Cancer knowledge, exposure beliefs, and prevention behaviors in Iowa's agricultural communities
- Creators
- Caroline Shakti Powell
- Contributors
- Diane S Rohlman (Advisor)Brandi Janssen (Committee Member)Jong Sung Kim (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Occupational and Environmental Health (Agricultural Safety and Health)
- Date degree season
- Spring 2026
- DOI
- 10.25820/etd.008414
- Publisher
- University of Iowa
- Number of pages
- xi, 130 pages
- Copyright
- Copyright 2026 Caroline S Powell
- Grant note
- Fellowship and research support was provided by the Heartland Center for Occupational Safety and Health at the University of Iowa. The Heartland Center is supported by Training Grant No. T42OH008491 from the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health.
- Language
- English
- Date submitted
- 04/23/2026
- Description illustrations
- illustrations, tables, graphs
- Description bibliographic
- Includes bibliographical references (pages 90-106).
- Public Abstract (ETD)
Agricultural environments contain multiple chemical, physical, and biological hazards that contribute to cancer risk, yet little is known about how people living and working in these settings understand cancer risk factors and engage in prevention behaviors. This is especially relevant in Iowa, where there is growing public concern over the potential role of agricultural exposures in the state’s high cancer rates. A survey was conducted to better understand cancer knowledge, exposure beliefs, cancer information sources, and risk reduction behaviors among individuals in Iowa’s agricultural communities. A total of 228 responses from farmers, family members, agricultural workers, and non-agricultural rural residents were analyzed.
Respondents recognized that cancer could take a long time to develop and results from a combination of genetic, behavioral, and environmental factors. Most identified established risk factors such as tobacco, asbestos, radon, diet, water contaminants, pesticides, and genetic predisposition, but were less familiar with other common carcinogens in agriculture, such as diesel exhaust and wood dust. Most participants expressed concern about agricultural exposures contributing to increased cancer risk, felt less control over risk reduction at work, and trusted healthcare providers and health organizations the most for cancer information. Many participants believed that risk reduction behaviors, including private well water testing, sun protection, personal protective equipment (PPE) use, and radon testing, could reduce cancer risk in agricultural settings, but fewer reported practicing these behaviors. These findings highlight opportunities to strengthen cancer risk reduction and risk communication efforts in Iowa by building cancer control and agricultural safety and health partnerships.
- Academic Unit
- Occupational and Environmental Health
- Record Identifier
- 9985176871102771
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