Cancer symptom awareness and barriers to symptomatic presentation in England—are we clear on cancer?

Nikšić, Maja; Rachet, Bernard; Warburton, Fiona; Wardle, Jane; Ramirez, Amanda-Jane; Forbes, Lindsay

doi:10.1038/bjc.2015.164

Cited by 85 publications

(82 citation statements)

References 39 publications

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“…This corresponds to the surveys showing that awareness of cancer warning signs is low, especially among young men and lower socio–economic groups [26,27]. In addition, almost a quarter of all cancer patients in England present as emergencies, often with the later stage of cancers and poorer outcomes [28].…”

Section: Discussionsupporting

confidence: 62%

Preventing delayed diagnosis of cancer: clinicians’ views on main problems and solutions

Car¹,

Papachristou²,

Urch³

et al. 2016

Journal of Global Health

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BackgroundDelayed diagnosis is a major contributing factor to the UK’s lower cancer survival compared to many European countries. In the UK, there is a significant national variation in early cancer diagnosis. Healthcare providers can offer an insight into local priorities for timely cancer diagnosis. In this study, we aimed to identify the main problems and solutions relating to delay cancer diagnosis according to cancer care clinicians.MethodsWe developed and implemented a new priority–setting approach called PRIORITIZE and invited North West London cancer care clinicians to identify and prioritize main causes for and solutions to delayed diagnosis of cancer care.ResultsClinicians identified a number of concrete problems and solutions relating to delayed diagnosis of cancer. Raising public awareness, patient education as well as better access to specialist care and diagnostic testing were seen as the highest priorities. The identified suggestions focused mostly on the delays during referrals from primary to secondary care.ConclusionsMany identified priorities were feasible, affordable and converged around common themes such as public awareness, care continuity and length of consultation. As a timely, proactive and scalable priority–setting approach, PRIORITZE could be implemented as a routine preventative system for determining patient safety issues by frontline staff.

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Section: Discussionsupporting

confidence: 62%

Preventing delayed diagnosis of cancer: clinicians’ views on main problems and solutions

Car¹,

Papachristou²,

Urch³

et al. 2016

Journal of Global Health

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“…This supports the view that British culture's value of stoicism and the “stiff upper lip” is something that women who are more acculturated might adopt. Emotional barriers were consistently more prevalent in all ethnic minority groups compared with White British women, particularly embarrassment, supporting previous research …”

Section: Discussionsupporting

confidence: 83%

Ethnic differences in barriers to symptomatic presentation in primary care: A survey of women in England

et al. 2019

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Objective The majority of cancers are diagnosed following a decision to access medical help for symptoms. People from ethnic minority backgrounds have longer patient intervals following identification of cancer symptoms. This study quantified ethnic differences in barriers to symptomatic presentation including culturally specific barriers. Correlates of barriers (eg, migration status, health literacy, and fatalism) were also explored. Methods A cross‐sectional survey of 720 White British, Caribbean, African, Indian, Pakistani, and Bangladeshi women aged 30 to 60 (n = 120/group) was carried out in England. Barrier items were taken from the widely used cancer awareness measure; additional culturally specific barriers to symptomatic presentation were included following qualitative work (11 barriers in total). Migration status, health literacy, and fatalism were included as correlates to help‐seeking barriers. Results Ethnic minority women reported a higher number of barriers (P < .001, 2.6‐3.8 more than White British women). Emotional barriers were particularly prominent. Women from ethnic minority groups were more likely to report “praying about a symptom” (P < .001, except Bangladeshi women) and “using traditional remedies” (P < .001, except Caribbean women). Among ethnic minority women, adult migration to the United Kingdom, low health literacy, and high fatalistic beliefs increased likelihood of reporting barriers to symptomatic presentation. For example, women who migrated as adults were more likely to be embarrassed (OR = 1.83; CI, 1.06‐3.15), worry what the GP might find (OR = 1.91; CI, 1.12‐3.26), and be low on body vigilance (OR = 4.44; CI, 2.72‐7.23). Conclusions Campaigns addressing barriers to symptomatic presentation among ethnic minority women should be designed to reach low health literacy populations and include messages challenging fatalistic views. These would be valuable for reducing ethnic inequalities in cancer outcomes.

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“…It was also observed that those who had completed Year 12 education were 5.8 times more likely to report a red patch compared with those with no formal education. A previous study by Niksic et al supported this by showing that participants with no school education were less likely to report the common signs and symptoms of cancer. Park et al found a similar result, with participants with university degrees more likely to identify a correct sign or symptom compared with those with less than Year 10 education.…”

Section: Discussionmentioning

confidence: 80%

Awareness and knowledge of oral cancer amongst adult dental patients attending regional university clinics in New South Wales, Australia: a questionnaire-based study

Zachar

Huang

Yates

2020

International Dental Journal

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Background Greater awareness and knowledge of oral cancer has been shown to increase patient presentation for opportunistic screening. This study aimed to identify the level of awareness and knowledge of oral cancer amongst adult patients in regional New South Wales. Methods A total of 444 adult dental patients participated in a self‐administered questionnaire at one of five regional university dental clinics between 23rd May and 25th July. Data analyses were performed using the chi‐square test and binary logistic regression to compare sociodemographic characteristics and the self‐declared awareness and knowledge of oral cancer. Results The study revealed that 73.8% of patients were aware of oral cancer; however, only 28.8% knew that they had been previously screened for oral cancer. Being female (P < 0.001, OR = 2.57), having an excellent level of oral health (P = 0.042, OR = 3.34) and previous attendance at a dental clinic of the regional university (P = 0.014, OR = 2.89) significantly enhanced awareness of oral cancer. Conclusion The findings of this study have broad implications for both clinicians and public health professionals, providing a platform for discussion regarding the sociodemographic factors contributing to reduced knowledge and awareness of oral cancer amongst patients. This study also identified an essential avenue to allow a more targeted approach in future campaigns to increase education.

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Cancer symptom awareness and barriers to symptomatic presentation in England—are we clear on cancer?

Cited by 85 publications

References 39 publications

Preventing delayed diagnosis of cancer: clinicians’ views on main problems and solutions

Preventing delayed diagnosis of cancer: clinicians’ views on main problems and solutions

Ethnic differences in barriers to symptomatic presentation in primary care: A survey of women in England

Awareness and knowledge of oral cancer amongst adult dental patients attending regional university clinics in New South Wales, Australia: a questionnaire-based study

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