Anticipated help-seeking for cancer symptoms before and after the coronavirus pandemic: results from the Onco-barometer population survey in Spain

Abstract

Background The patient interval—the time patients wait before consulting their physician after noticing cancer symptoms—contributes to diagnostic delays. We compared anticipated help-seeking times for cancer symptoms and perceived barriers to help-seeking before and after the coronavirus pandemic. Methods Two waves (pre-Coronavirus: February 2020, N = 3269; and post-Coronavirus: August 2020, N = 1500) of the Spanish Onco-barometer population survey were compared. The international ABC instrument was administered. Pre–post comparisons were performed using multiple logistic and Poisson regression models. Results There was a consistent and significant increase in anticipated times to help-seeking for 12 of 13 cancer symptoms, with the largest increases for breast changes (OR = 1.54, 95% CI 1.22–1–96) and unexplained bleeding (OR = 1.50, 1.26–1.79). Respondents were more likely to report barriers to help-seeking in the post wave, most notably worry about what the doctor may find (OR = 1.58, 1.35–1.84) and worry about wasting the doctor’s time (OR = 1.48, 1.25–1.74). Women and older individuals were the most affected. Conclusions Participants reported longer waiting times to help-seeking for cancer symptoms after the pandemic. There is an urgent need for public interventions encouraging people to consult their physicians with symptoms suggestive of cancer and counteracting the main barriers perceived during the pandemic situation.

Cancer symptom experience and help-seeking behaviour during the COVID-19 pandemic in the UK: a cross-sectional population survey

“…Similarly to previous research, key help-seeking barriers in the current study included worry about wasting healthcare professionals’ time, overstretching limited healthcare resources and accessing healthcare services (personal communication). 28 35 In a Spanish population sample, Petrova et al 36 also reported barriers to anticipated symptom help-seeking during the COVID-19 pandemic including worry about wasting the doctor’s time and worry about what the doctor might find. International prepandemic research on barriers to help-seeking has found that UK adults are more likely to report worry about ‘bothering the doctor’ compared with those in other high-income countries.…”

Predicted long‐term impact of COVID‐19 pandemic‐related care delays on cancer mortality in Canada

“… 2 Many individuals have delayed consulting for cancer‐related symptoms due to access barriers, or fears of infection with coronavirus in a healthcare setting. 3 , 4 Healthcare staffing shortages may occur due to redeployment to the pandemic response, leave due to coronavirus infection, burnout or increased childcare responsibilities. Key cancer diagnostic tests, such as endoscopies, colonoscopies, mammographies, computerized tomography (CT) scans and magnetic resonance imaging (MRI) scans, have declined, 5 , 6 either due to fewer patient referrals or delays in accessing these services.…”

Primary healthcare professionals’ perspectives on patient help-seeking for lung cancer warning signs and symptoms: a qualitative study

“…A survey of 7543 adults in the UK found that approximately half of patients who reported experiencing cancer alarm signs and symptoms did not contact their general practitioner (GP) due to concerns about catching or transmitting COVID-19 [ 11 ]. Another survey of 3269 individuals in Spain found that participants reported significantly longer waiting times to help-seeking for cancer symptoms due to fears of overburdening the healthcare system during the pandemic [ 12 ].…”