Causal Attributions in Patients With Breast and Gynecological Cancers: A Scoping Review

Abstract

Objective: Understanding how patients with cancer attribute their illness is crucial for improving public health interventions and support strategies. This scoping review explores perceived causal attributions among women with breast and gynecological cancers, focusing on quantitative studies. It further examines regional and temporal patterns and identifies gaps in public awareness. Methods: A literature search was conducted in four electronic databases: PubMed, EMBASE, CINAHL, and APA PsycINFO. Eligible studies focusing on women diagnosed with breast or gynecological cancers and their perceived causal attributions were included. Filters were applied for language (English, Korean), publication type (original article), and time-period (1949–2025). Data were extracted, categorized, and analyzed descriptively. Results: Our search identified 3072 studies, of which 41 met the inclusion criteria. Psychological risk factors, particularly stress, were the most frequently reported top-ranked causal attributions (50.0%), followed by biological risk factors (23.8%), while behavioral risk factors were under-recognized. The Western population was more focused on biological risk factors, whereas non-Western population more frequently reported psychological and environmental factors. Moreover, studies published after 2015 reported an increased emphasis on psychological risk factors, while attributions to fate or chance diminished significantly. Conclusion: The persistent over-attribution of psychological risk factors and under-recognition of behavioral risk factors highlight the need for targeted education and campaigns. Cultural and societal influences shape these perceptions, emphasizing the importance of evidence-based education to improve cancer awareness and prevention strategies.