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Educational differences in likelihood of attributing breast symptoms to cancer: a vignette-based study

Marcu, Afrodita, Lyratzopoulos, G, Black, G, Vedsted, P and Whitaker, Katriina (2016) Educational differences in likelihood of attributing breast symptoms to cancer: a vignette-based study Psycho-Oncology, 25 (10). pp. 1191-1197.

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Abstract

Background Stage at diagnosis of breast cancer varies by socio-economic status (SES), with lower SES associated with poorer survival. We investigated associations between SES (indexed by education), and the likelihood of attributing breast symptoms to breast cancer. Method We conducted an online survey with 961 women (47-92 years) with variable educational levels. Two vignettes depicted familiar and unfamiliar breast changes (axillary lump and nipple rash). Without making breast cancer explicit, women were asked ‘What do you think this […..] could be?’ After the attribution question, women were asked to indicate their level of agreement with a cancer avoidance statement (‘I would not want to know if I have breast cancer’). Results Women were more likely to mention cancer as a possible cause of an axillary lump (64%) compared with nipple rash (30%). In multivariable analysis, low and mid education were independently associated with being less likely to attribute a nipple rash to cancer (OR 0.51, 0.36-0.73 and OR 0.55, 0.40-0.77, respectively). For axillary lump, low education was associated with lower likelihood of mentioning cancer as a possible cause (OR 0.58, 0.41-0.83). Although cancer avoidance was also associated with lower education, the association between education and lower likelihood of making a cancer attribution was independent. Conclusion Lower education was associated with lower likelihood of making cancer attributions for both symptoms, also after adjustment for cancer avoidance. Lower likelihood of considering cancer may delay symptomatic presentation and contribute to educational differences in stage at diagnosis.

Item Type: Article
Subjects : subj_Health_Care
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Marcu, Afroditaafrodita.marcu@surrey.ac.ukUNSPECIFIED
Lyratzopoulos, GUNSPECIFIEDUNSPECIFIED
Black, GUNSPECIFIEDUNSPECIFIED
Vedsted, PUNSPECIFIEDUNSPECIFIED
Whitaker, Katriinak.whitaker@surrey.ac.ukUNSPECIFIED
Date : 16 June 2016
Identification Number : 10.1002/pon.4177
Copyright Disclaimer : This is the peer reviewed version of an article which has been accepted for publication in Psycho-Oncology. The final published version can be accessed at http://onlinelibrary.wiley.com/journal/10.1002/pon.4177. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 20 May 2016 18:20
Last Modified : 26 Jul 2017 13:22
URI: http://epubs.surrey.ac.uk/id/eprint/810780

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