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Low cancer suspicion following experience of a cancer ‘warning sign’

Whitaker, Katriina, Winstanley, Kelly, Macleod, Una, Scott, Suzanne E. and Wardle, Jane (2015) Low cancer suspicion following experience of a cancer ‘warning sign’ European Journal of Cancer, 51 (16). pp. 2473-2479.

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Aim Lower socioeconomic status (SES) is associated with a higher risk of late-stage cancer diagnosis. A number of explanations have been advanced for this, but one which has attracted recent attention is lower patient knowledge of cancer warning signs, leading to delay in help-seeking. However, although there is psychometric evidence of SES differences in knowledge of cancer symptoms, no studies have examined differences in ‘cancer suspicion’ among people who are actually experiencing a classic warning sign. Methods A ‘health survey’ was mailed to 9771 adults (⩾50 years, no cancer diagnosis) with a symptom list including 10 cancer ‘warning signs’. Respondents were asked if they had experienced any of the symptoms in the past 3 months, and if so, were asked ‘what do you think caused it?’ Any mention of cancer was scored as ‘cancer suspicion’. SES was indexed by education. Results Nearly half the respondents (1732/3756) had experienced a ‘warning sign’, but only 63/1732 (3.6%) mentioned cancer as a possible cause. Lower education was associated with lower likelihood of cancer suspicion: 2.6% of respondents with school-only education versus 7.3% with university education suspected cancer as a possible cause. In multivariable analysis, low education was the only demographic variable independently associated with lower cancer suspicion (odds ratio (OR) = 0.34, confidence interval (CI): 0.20–0.59). Conclusion Levels of cancer suspicion were low overall in this community sample, and even lower in people from less educated backgrounds. This may hinder early symptomatic presentation and contribute to inequalities in stage at diagnosis.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
Winstanley, Kelly
Macleod, Una
Scott, Suzanne E.
Wardle, Jane
Date : 8 August 2015
DOI : 10.1016/j.ejca.2015.07.014
Copyright Disclaimer : © 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (
Uncontrolled Keywords : Socioeconomic factors; Cancer; Signs and symptoms; Delayed diagnosis
Depositing User : Clive Harris
Date Deposited : 25 Aug 2017 08:06
Last Modified : 16 Jan 2019 18:55

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