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Is lower symptom recognition associated with socioeconomic inequalities in help-seeking for potential breast cancer symptoms?

Davies, Hilary, Marcu, Afrodita, Vedsted, P and Whitaker, Katriina (2017) Is lower symptom recognition associated with socioeconomic inequalities in help-seeking for potential breast cancer symptoms? Psycho-Oncology.

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Abstract

Objective:

Socioeconomic inequalities in recognising signs and symptoms of cancer may result in inequalities in timely help-seeking and subsequent prognosis of breast cancer. We explored the mediating role of symptom attribution and concern on the relationship between level of education and help-seeking for potential breast cancer symptoms.

Methods:

Women aged ≥47 years (n=961) were purposively recruited (by education) to complete an online vignette-based survey that included nipple rash and axillary lump (in separate vignettes) as potential symptoms of breast cancer. Women completed questions relating to medical help-seeking (Yes/No), cancer attribution, symptom concern, cancer avoidance, family history and demographics.

Results:

Women with low education and mid-education attributed nipple rash less often to cancer (26% and 27% mentioned cancer) than women with a degree or higher (40%). However, women with a degree or higher (63%) or mid-education (64%) were less likely to anticipate seeking help for the nipple rash than women with no formal qualifications (73%). This association was statistically significant in the 60-69 year old age group. There was no significant association between education and help-seeking for axillary lump. Mediation analysis adjusting for potential confounders confirmed that the association between education and help-seeking for nipple rash was fully mediated by symptom concern.

Conclusions:

Socioeconomic inequalities in stage at diagnosis and survival of breast cancer may not always be explained by lower likelihood of suspecting cancer and subsequent impact on help-seeking. Reducing inequalities in stage at diagnosis will involve understanding a broader range of bio-psycho-social factors (e.g. comorbidities, healthcare system factors).

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Davies, Hilaryhilary.davies@surrey.ac.ukUNSPECIFIED
Marcu, Afroditaafrodita.marcu@surrey.ac.ukUNSPECIFIED
Vedsted, PUNSPECIFIEDUNSPECIFIED
Whitaker, Katriinak.whitaker@surrey.ac.ukUNSPECIFIED
Date : 14 December 2017
Copyright Disclaimer : This is the author's version of an article accepted for publication in Psycho-Oncology, after peer-review. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords : Cancer, oncology, breast cancer, educational status, help-seeking behaviour, oncology, signs and symptoms
Depositing User : Melanie Hughes
Date Deposited : 14 Sep 2017 10:48
Last Modified : 14 Sep 2017 10:54
URI: http://epubs.surrey.ac.uk/id/eprint/842271

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