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 While Britain provides health care for everyone and has campaigns to
boost cancer awareness, the researchers found that many groups need
more education and encouragement to seek help for symptoms.
“Many campaigns are still not targeted to specific population
subgroups, and a ‘one-size-fits-all’ approach is not likely to be
the most effective,” said lead author Maja Niksic, a doctoral
student in cancer epidemiology and population health at King’s
College London.
Niksic said her own father did not recognize his cancer symptoms and
delayed seeing a doctor until her mother, a physician, insisted.
“People often do not prioritize their health until they get ill,"
Niksic said. Or they may have trouble knowing the warning signs, she
noted.
People should seek medical advice for any persistent and unexplained
changes in their body, she and her colleagues say, such as an
unexplained lump or swelling, change in the appearance of a mole,
change in bowel or bladder habits, unexplained bleeding, unexplained
weight loss, persistent unexplained pain, persistent difficulty
swallowing, a sore that does not heal, or persistent cough or
hoarseness.
As reported in the British Cancer Journal, the researchers analyzed
data on nearly 39,000 women and men from 18 surveys on cancer
awareness across England during 2009-2011. Although similar to the
general population in gender and age, the survey participants were,
on average, of lower socioeconomic status.
On average, participants recognized about seven out of nine common
cancer signs and symptoms. Forty percent recognized all nine.
People aged 55 to 74 were most likely to recognize all the signs and
symptoms of possible cancer.
About two thirds of participants identified at least one barrier to
seeking medical help and about one third reported three or more
barriers.
Women faced more emotional barriers to seeking treatment than men
and were 40 percent more likely to put off seeing a doctor because
they were “too scared.” Single people were also reluctant to seek
help because of emotional barriers.
People living in poorest areas were 37 percent more likely than the
most affluent to overlook the nine common cancer signs and symptoms.
Residents of deprived areas and those with low education levels were
more likely to delay seeing a doctor because of embarrassment, fear
and transportation difficulties than those living in affluent areas
or with more education.
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“Clinicians know that these patients tend to be vulnerable, but I
think the study does a really good job of highlighting that with
real data and showing that this is a very significant problem,” said
Supriya Mohile, who directs geriatric oncology at the Wilmot Cancer
Institute of the University of Rochester Medical Center in New York
state.
“Also, this will guide future interventions in terms of trying to
close this knowledge gap where the most vulnerable patients aren’t
getting the appropriate care,” said Mohile, who was not involved in
the study.
Elderly people also reported trouble arranging transportation to the
doctor, as did people who were married but separated.
The authors point out that although England has a National Health
Service, underprivileged people may still have trouble accessing
medical care. They suggest raising awareness in poor communities and
reassuring people about the benefits of early detection.
“The elderly might benefit more from educational campaigns aimed at
improving their understanding of potential symptoms of cancer, and,
perhaps, differentiating these from other age-specific disorders,
such as osteoarthritis,” said Niksic. “Both groups (the
underprivileged and the elderly) need to have affordable and
appropriate transport options to reach health services.”
Mohile said she suspected the gaps in knowledge and willingness to
seek medical care were even greater in the U.S., where there's more
"more variability in access to health care.”
“I think some of the conditions that they talked about here like
being embarrassed, fearful, difficulty in transportation are very
common too in the U.S., so there’s a lot of denial,” Mohile said by
email.
SOURCE: http://bit.ly/1Di0vXL British Journal of Cancer, online June
30, 2015.
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