Unexpected Risk Factor Leads to Late Diagnoses

August 28, 2025, 2:33 am | Read time: 5 minutes

Preventive health care is one of the best measures to either completely avoid serious illnesses or detect them at an early stage. The earlier a disease is detected, the better the treatment options. Researchers at the Max Planck Institute have now discovered why many people forgo preventive health care—and how this can become an unexpected risk factor for late diagnoses. FITBOOK author Martin Lewicki presents the findings and speaks with lead author and doctoral candidate Konstantin Offer.

How many people avoid preventive health care, also known as check-ups, for early detection of diseases? And what risk factors lead to late diagnoses? Scientists at the Max Planck Institute for Human Development in Berlin sought to find out. They analyzed data from a total of 92 international studies with 564,497 participants in a meta-analysis.¹ The study participants came from 25 countries, including Germany. Globally, information is lacking on how widespread the avoidance of medical examinations is and the reasons behind it. The study shows that fear as a risk factor plays a crucial role in late diagnoses.

What is Information Avoidance?

How is the avoidance of preventive health care determined? The researchers have established their own definition for this. “Any form of behavior aimed at preventing or delaying the acquisition of available but potentially unwanted information,” they write in their study. They refer to this as information avoidance. This includes the following behaviors:

Postponing or not attending doctor visits
Avoiding medical tests
Not acknowledging test results
Ignoring educational materials

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What Did the Study Reveal?

The researchers took a closer look at the following diseases during the data analysis:

Alzheimer’s
Huntington’s
HIV/AIDS
Cancer
Diabetes

The analysis of data from more than half a million people revealed that almost a third of them avoid or will avoid medical information. The rate was highest for incurable neurodegenerative diseases like Alzheimer’s. It was slightly lower for treatable diseases like HIV and cancer. According to the researchers, avoidance behavior was lowest for well-treatable chronic diseases like diabetes. Here are the detailed results:

41 percent of participants avoided medical information about Alzheimer’s
40 percent of participants avoided medical information about Huntington’s
32 percent of participants avoided medical information about HIV infections
29 percent of participants avoided medical information about cancer
24 percent of participants avoided medical information about diabetes

The data shows: The more severe and incurable a disease is, the more people ignore information offers or preventive health care related to it. But why is this the case? The researchers at the Max Planck Institute provide some answers. They identified 16 key factors that promote avoidance behavior. Interestingly, neither gender nor ethnicity plays a role. Instead, the following risk factors are predominant:

Cognitive Overload: This means that a disease is perceived as too complex and overwhelming.
A low sense of self-efficacy: This involves the feeling of being helpless and not in control of one’s health.
Fear of Stigmatization: This is particularly pronounced in socially stigmatized diseases like HIV/AIDS.
Lack of trust in the medical system: Here, affected individuals have little hope of being well-treated.

Are There Country-Specific Differences?

Unfortunately, the researchers do not make a direct comparison between the individual nations studied. The study does not show whether the behavior in Germany is different from, for example, the United States or other European countries. According to lead author Konstantin Offer, a doctoral candidate in the Adaptive Rationality research area at the Max Planck Institute for Human Development, slight variations are evident: “We see indications of regional differences—such as regarding the ‘trust’ factor between Africa and North America.” However, he emphasizes: “The current data is not sufficient for reliable comparisons at the country level.”

Offer sees a need for further research on the following questions, in addition to country-specific differences:

How much does information avoidance vary within individuals and population groups?
What does it look like for other diseases?
When might information avoidance be sensible, and when is it harmful?
What are its long-term consequences for individuals and societies?

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How Can the Health System Respond?

“Our findings suggest that a decline in trust is accompanied by an increase in information avoidance,” says Offer.² “Increasing trust in the medical system could therefore lead to greater engagement with medical information.” Therefore, the researchers advise focusing on this area. The identified reasons must be taken seriously to alleviate people’s fears. Political measures are needed to promote more education.

How Study Author Offer Envisions Improvements

Offer suggested a 2019 study to FITBOOK that dealt with the issue of trust in the health system.³ It presents transparency, open communication, and stronger personal relationships as the most important levers. For example, consistent involvement of doctors and nurses in leadership processes, empathetic and respectful interactions with patients, and clear accountability in decisions and mistakes. Additionally, collegial support among professionals, diversity, and burnout prevention would foster a trustworthy environment.

Conclusion

The results show that information avoidance in the medical context is a widespread phenomenon affecting about a third of the population. This behavior is particularly pronounced in severe or incurable diseases like Alzheimer’s, Huntington’s, or HIV. The avoidance manifests not only in the rejection of informational materials but also in evading tests or doctor visits.

This tendency has far-reaching consequences: It hinders the early detection of diseases, influences therapy decisions, and negatively impacts general health behavior. Information avoidance is neither a fringe phenomenon nor an expression of irrationality but is significantly driven by emotional burdens, cognitive overload, distrust of the health system, and stigmatization. Ultimately, it is fear as a risk factor that leads to late diagnoses.

Therefore, the researchers advise that measures to promote preventive readiness should not rely solely on knowledge dissemination. Instead, they should specifically address people’s fears to reach those affected.

This article is a machine translation of the original German version of FITBOOK and has been reviewed for accuracy and quality by a native speaker. For feedback, please contact us at info@fitbook.de.