Background
Promoting early presentation
Methods
Study design
Setting and Sample
Recruitment and consent
Survey instrument
Cancer awareness
Socio-demographic characteristics
Anxiety
Deprivation
Data analysis
Ethical considerations
Results
Sample
All (n = 2,173) | ||||
---|---|---|---|---|
Mean | SD | % | n | |
Age
| 12.4 | 0.55 | ||
Gender
| ||||
Male | 47.5 | 1,032 | ||
Female | 50.7 | 1,102 | ||
Missing | 1.8 | 39 | ||
Knew someone with cancer
| ||||
Yes | 58.3 | 1,266 | ||
No | 36.0 | 783 | ||
Missing | 5.7 | 124 | ||
Ethnicity
| ||||
White | 84.0 | 1,826 | ||
BME#
| 14.1 | 306 | ||
Mixed | 3.5 | 75 | ||
Asian | 6.0 | 131 | ||
Black | 2.6 | 57 | ||
Chinese | 0.7 | 15 | ||
Other | 1.3 | 28 | ||
Missing | 1.9 | 41 | ||
Deprivation (SIMD
†
)
| ||||
Quintile 1 | 55.5 | 1,205 | ||
Quintiles 2-5 | 34.0 | 739 | ||
Missing | 10.5 | 229 | ||
Anxiety (HADS
‡
)
| ||||
Total score (Mean (SD)) | 7.2 | (4.19) | ||
No emotional disorder | 66.3 | 1,212 | ||
Possible emotional disorder | 18.0 | 329 | ||
Probable emotional disorder | 15.7 | 286 |
Recognition of cancer warning signs
Cancer warning sign % Yes (n) | Gender (n = 2,134) | Knew someone with cancer (n = 2,049) | Ethnicity (n = 2,132) | Deprivation (SIMD†) (n = 1,944) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Male (n = 1,032) | Female (n = 1,102) | Significance* | Yes (n = 1,266) | No (n = 783) | Significance* | White (n = 1,826) | BME#(n = 306) | Significance* | Q1 (n = 1,205) | Q2-5 (n = 739) | Significance* | |
Lump or swelling | 72.7 (744) | 84.9 (931) | χ2(1, 2120) = 48.21 p < 0.001 | 82.5 (1040) | 72.8 (567) | χ2(1,2040) = 27.03 p < 0.001 | 80.8 (1469) | 68.5 (207) | χ2(1,2119) = 23.71 p < 0.001 | 79.9 (949) | 77.8 (572) | χ2(1,1923) = 1.16 p = 0.281 |
Change in bowel/bladder habits | 54.9 (562) | 55.8 (609) | χ2(1,2116) = 0.17 p = 0.682 | 60.4 (760) | 48.8 (379) | χ2(1,2036) = 26.18 p < 0.001 | 56.7 (1028) | 47.5 (144) | χ2(1,2115) = 8.91 p = 0.003 | 53.3 (633) | 59.2 (433) | χ2(1,1919) = 6.22 p = 0.013 |
Change in appearance of a mole | 43.5 (444) | 48.0 (524) | χ2(1,2112) = 4.38 p = 0.036 | 49.0 (616) | 41.4 (321) | χ2(1,2032) = 11.10 p = 0.001 | 47.9 (866) | 33.0 (100) | χ2(1,2111) = 23.20 p < 0.001 | 45.4 (538) | 48.2 (352) | χ2(1,1916) = 1.38 p = 0.241 |
Unexplained bleeding | 46.5 (476) | 43.6 (475) | χ2(1,2113) = 1.86 p = 0.173 | 47.4 (596) | 41.3 (320) | χ2(1,2033) = 7.18 p = 0.007 | 45.3 (821) | 41.9 (126) | χ2(1,2112) = 1.26 p = 0.262 | 44.2 (523) | 46.6 (341) | χ2(1,1916) = 1.06 p = 0.302 |
Unexplained pain | 43.7 (448) | 44.2 (481) | χ2(1,2113) = 0.05 p = 0.816 | 45.7 (575) | 41.5 (322) | χ2(1,2033) = 3.51 p = 0.061 | 43.7 (791) | 44.7 (135) | χ2(1,2112) = 0.11 p = 0.746 | 42.1 (499) | 46.4 (340) | χ2(1,1918) = 3.36 p = 0.067 |
Unexplained weight loss | 40.9 (418) | 43.7 (477) | χ2(1,2113) = 1.62 p = 0.203 | 47.4 (595) | 35.4 (275) | χ2(1,2033) = 28.14 p < 0.001 | 42.9 (776) | 39.4 (119) | χ2(1,2112) = 1.28 p = 0.259 | 43.8 (519) | 40.2 (294) | χ2(1,1917) = 2.45 p = 0.118 |
Cough or hoarseness | 37.2 (381) | 30.9 (337) | χ2(1,2114) = 9.51 p = 0.002 | 36.2 (455) | 29.7 (231) | χ2(1,2034) = 9.18 p = 0.002 | 33.7 (610) | 36.6 (111) | χ2(1,2113) = 0.99 p = 0.319 | 33.9 (402) | 35.7 (261) | χ2(1,1918) = 0.62 p = 0.431 |
Difficulty swallowing | 33.8 (345) | 34.2 (372) | χ2(1,2110) = .003 p = 0.858 | 37.8 (474) | 28.4 (220) | χ2(1,2030) = 19.02 p < 0.001 | 35.6 (644) | 24.9 (75) | χ2(1,2109) = 13.15 p < 0.001 | 34.6 (410) | 33.8 (247) | χ2(1,1915) = 0.12 p = 0.732 |
Sore that does not heal | 27.5 (280) | 25.5 (277) | χ2(1,2106) = 1.02 p = 0.312 | 28.7 (359) | 23.5 (182) | χ2(1,2026) = 6.37 p = 0.012 | 25.8 (466) | 29.1 (88) | χ2(1,2105) = 1.45 p = 0.229 | 24.9 (294) | 27.7 (202) | χ2(1,1910) = 1.86 p = 0.173 |
95% CI | ||||
---|---|---|---|---|
Variable | IRR†
| Lower | Upper | p |
Intercept | 3.78 | 3.59 | 3.98 | <0.001 |
Ethnicity
| ||||
BME | 0.92 | 0.86 | 0.99 | 0.023 |
White | - | - | - | - |
Knew someone with cancer
| ||||
Yes | 1.19 | 1.13 | 1.25 | <0.001 |
No | - | - | - | - |
SIMD
| ||||
Quintile 1 (most deprived) | 0.95 | 0.91 | 1.00 | 0.043 |
Quintiles 2-5 | - | - | - | - |
Barriers to help seeking
Barrier | Gender (n = 2,134) | Knew someone with cancer (n = 2,049) | Ethnicity (n = 2,132) | Deprivation (SIMD†) (n = 1,944) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
% Yes (n) | Male (n = 1,032) | Female (n = 1,102) | Significance* | Yes (n = 1,266) | No (n = 783) | Significance* | White (n = 1,826) | BME#(n = 306) | Significance* | Q1 (n = 1,205) | Q2-5 (n = 739) | Significance* |
Emotional | ||||||||||||
Worried about what the doctor might find | 65.0 (639) | 78.3 (837) | χ2(1, 2052) = 44.81, p < 0.001 | 74.5 (905) | 68.0 (516) | χ2(1, 1973) = 9.98, p = 0.002 | 72.7 (1274) | 66.1 (197) | χ2(1, 2051) = 5.42, p = 0.002 | 72.7 (832) | 71.8 (515) | χ2(1, 1862) = 0.15, p = 0.694 |
Too scared | 45.8 (452) | 68.2 (732) | χ2(1, 2059) = 105.3, p < 0.001 | 61.1 (750) | 51.7 (390) | χ2(1,1982) = 16.72,p < 0.001 | 58.0 (1023) | 53.0 (157) | χ2(1, 2059) = 2.58, p = 0.109 | 56.1 (646) | 59.1 (424) | χ2(1, 1869) = 1.69, p = 0.194 |
Not confident to talk about symptoms | 41.4 (404) | 54.7 (578) | χ2(1, 2032) = 36.15, p < 0.001 | 49.2 (590) | 46.2 (349) | χ2(1, 1955) = 1.72, p = 0.190 | 48.4 (839) | 46.5 (139) | χ2(1, 2031) = 0.39, p = 0.533 | 47.2 (534) | 49.9 (356) | χ2(1, 1844) = 1.29, p = 0.256 |
Too embarrassed | 37.8 (370) | 57.5 (612) | χ2(1, 2044) = 79.83, p < 0.001 | 49.2 (597) | 45.9 (346) | χ2(1, 1967) = 2.06, p = 0.151 | 48.1 (841) | 46.4 (137) | χ2(1, 2044) = 0.27, p = 0.601 | 46.9 (536) | 47.5 (388) | χ2(1, 1855) = 0.08, p = 0.774 |
Family | ||||||||||||
I wouldn’t want my family to find out | 34.3 (336) | 37.4 (395) | χ2(1, 2035) = 2.20, p = 0.138 | 36.7 (442) | 34.0 (257) | χ2(1, 1959) = 1.53, p = 0.217 | 36.3 (631) | 33.1 (98) | χ2(1, 2034) = 1.13, p = 0.289 | 37.6 (427) | 32.5 (232) | χ2(1, 1848) = 4.93, p = 0.026 |
Service Barriers | ||||||||||||
Difficult to talk to doctor | 25.6 (247) | 34.1 (358) | χ2(1, 2014) = 17.41, p < 0.001 | 30.9 (368) | 28.3 (211) | χ2(1, 1938) = 1.47, p = 0.226 | 30.4 (523) | 26.4 (78) | χ2(1, 2014) = 1.91, p = 0.167 | 30.2 (340) | 28.4 (200) | χ2(1, 1829) = 0.68, p = 0.408 |
Worried about wasting the doctor’s time | 25.8 (251) | 32.6 (342) | χ2(1, 2022) = 11.09, p = 0.001 | 29.8 (357) | 27.8 (208) | χ2(1, 1947) = 0.81, p = 0.368 | 30.0 (520) | 24.4 (71) | χ2(1, 2022) = 3.83, p = 0.050 | 28.8 (324) | 28.3 (201) | χ2(1, 1836) = 0.05, p = 0.830 |
Difficult to make an appointment | 22.5 (217) | 22.4 (235) | χ2(1, 2014) = 0.00, p = 0.983 | 23.4 (279) | 21.3 (158) | χ2(1, 1937) = 1.16, p = 0.282 | 21.6 (372) | 27.9 (82) | χ2(1, 2014) = 5.64, p = 0.018 | 22.5 (253) | 21.2 (149) | χ2(1, 1829) = 0.44, p = 0.506 |
Practical Barriers | ||||||||||||
Too busy | 20.6 (202) | 19.5 (206) | χ2(1, 2038) = 0.44, p = 0.506 | 19.5 (234) | 20.6 (156) | χ2(1, 1960) = 0.36, p = 0.548 | 19.2 (334) | 23.8 (71) | χ2(1, 2037) = 3.41, p = 0.065 | 19.6 (223) | 20.3 (144) | χ2(1, 1849) = 0.15, p = 0.695 |
Other things to worry about | 16.4 (160) | 22.2 (235) | χ2(1, 2034) = 10.84, p = 0.001 | 18.9 (226) | 20.2 (153) | χ2(1, 1956) = 0.52, p = 0.472 | 18.8 (327) | 22.5 (67) | χ2(1, 2033) = 2.15, p = 0.142 | 18.9 (214) | 18.7 (133) | χ2(1, 1845) = 0.00, p = 0.948 |
Difficult to arrange transport | 16.6 (162) | 12.1 (127) | χ2(1, 2027) = 8.54, p = 0.003 | 12.7 (152) | 16.3 (123) | χ2(1, 1950) = 4.79, p = 0.029 | 14.0 (242) | 16.2 (48) | χ2(1, 2026) = 1.02, p = 0.312 | 15.5 (176) | 12.7 (90) | χ2(1, 1840) = 2.83, p = 0.092 |
95% CI | ||||
---|---|---|---|---|
Variable | IRR†
| Lower | Upper | p |
Intercept | 2.41 | 2.25 | 2.58 | <0.001 |
Anxiety | 1.03 | 1.03 | 1.04 | <0.001 |
Cancer warning signs | 1.03 | 1.02 | 1.04 | <0.001 |
Gender
| ||||
Female | 1.24 | 1.18 | 1.30 | <0.001 |
Male | - | - | - | - |