Background
Methods
Translation
Forward translation
Backward translation
Pilot-test
Data quality
Content validity
Construct validity
Structural validity
Hypotheses testing
Test-retest reliability
Results
Translation
Final version
Data quality
Did not answer % (n) | Don’t knowa
% (n) | |
---|---|---|
Awareness of cancer symptoms | ||
Response options: yes; no. | ||
Q10. Persistent unexplained pain | 0 (0) | 3.4 (101) |
Q11. Unexplained bleeding | 0 (0) | 4.5 (135) |
Q14. Persistent difficulty in swallowing | 0 (0) | 3.4 (101) |
Q16. Sore that does not heal | 0 (1) | 4.5 (134) |
Q17. Unexplained night sweats | 0 (0) | 8.2 (245) |
Beliefs about cancer | ||
Response options: strongly disagree; tend to disagree; tend to agree; strongly agree. | ||
Q29. Most cancer treatment is worse than the cancer itself | 0.3 (8) | 9.9 (296) |
Awareness of 5-year survival from cancer | ||
Response options: 0; 1; 2; 3; 4; 5; 6; 7; 8; 9; 10. | ||
Q34. Out of 10 people diagnosed with bowel cancer, how many do you think would be alive 5 years later? | 0.1 (3) | 5.0 (151) |
Q36. Out of 10 people diagnosed with ovarian cancer, how many do you think would be alive 5 years later? | 0.2 (5) | 6.3 (189) |
Q37. Out of 10 people diagnosed with lung cancer, how many do you think would be alive 5 years later? | 0.2 (5) | 3.1 (93) |
Awareness of risk factors for cancer | ||
Response options: strongly disagree; tend to disagree; tend to agree; strongly agree | ||
QN3. Drinking more than 1 unit of alcohol a day | 0 (0) | 3.1 (94) |
QN5. Eating red or processed meat once a day or more | 0 (1) | 7.5 (224) |
QN6. Being obese | 0 (1) | 4.1 (124) |
QN8. Being over 70 years old | 0 (1) | 3.2 (96) |
QN9. Having a close relative with cancer | 0.1 (2) | 3.1 (94) |
QN10. Infection with HPV, Human Papillomavirus | 0 (0) | 68.3 (2050) |
QN13. Exposure to ionising radiation from, for example, radioactive materials, x-rays or radon | 0.1 (2) | 3.8 (114) |
Content validity
Construct validity
Structural validity
Subscale and items | Factor loadings | |||||||
---|---|---|---|---|---|---|---|---|
Factor 1 | Factor 2 | Factor 3 | Factor 4 | Factor 5 | Factor 6 | Factor 7 | Factor 8 | |
Anticipated patient interval for healthcare seeking | ||||||||
Q5. A persistent cough |
0.641
| |||||||
Q6. Rectal bleeding |
0.581
| |||||||
Q7. Any breast changesa
|
0.609
| |||||||
Q8. Abdominal bloating |
0.646
| |||||||
Awareness of cancer symptoms | ||||||||
Q9. Unexplained lump or swelling |
0.575
| |||||||
Q10. Persistent unexplained pain |
0.610
| |||||||
Q11. Unexplained bleeding |
0.594
| |||||||
Q12. Persistent cough or hoarseness |
0.713
| |||||||
Q13. Change in bowel or bladder habits |
0.637
| |||||||
Q14. Persistent difficulty in swallowing |
0.696
| |||||||
Q15. Change in the appearance of a mole |
0.605
| |||||||
Q16. Sore that does not heal |
0.572
| |||||||
Q17. Unexplained night sweats |
0.515
| |||||||
Q18. Unexplained weight loss |
0.713
| |||||||
Q19. Unexplained tiredness |
0.702
| |||||||
Anticipated barriers for healthcare seeking | ||||||||
Q24. I would be too embarrassed |
0.874
| |||||||
Q25. I would be worried about what the doctor might find |
0.630
| |||||||
Q26. I would be worried about wasting the doctor’s time |
0.379
| |||||||
Q27. I am too busy to make time to go to the doctor |
0.402
| |||||||
Beliefs about cancer | ||||||||
Q28. People with cancer can expect to continue with normal activities |
0.605
| |||||||
Q29. Most cancer treatment is worse than the cancer itself |
0.410
| |||||||
Q30. Not want to know if I have cancer |
0.533
| |||||||
Q31. Cancer can often be cured |
0.708
| |||||||
Q32. Going to the doctor as quickly as possible could increase the chances of surviving |
0.431
| |||||||
Q33. A diagnosis of cancer is a death sentence | 0.451 |
(0.312)
| ||||||
Beliefs about breast cancer screeninga
| ||||||||
QM3. So worried about what might be found at breast cancer screening, that I would prefer not to do it |
0.628
| |||||||
QM4. Breast cancer screening is only necessary if I have symptoms |
0.911
| |||||||
QM5. Breast cancer screening could reduce my chances of dying from breast cancer |
0.465
| |||||||
Beliefs about bowel cancer screening | ||||||||
QM6. So worried about what might be found at bowel cancer screening, that I would prefer not to do it |
0.643
| |||||||
QM7. Bowel cancer screening is only necessary if I have symptoms |
0.570
| |||||||
QM8. Bowel cancer screening could reduce my chances of dying from bowel cancer |
0.400
| |||||||
Awareness of risk factors for cancer | ||||||||
QN1. Smoking |
0.670
| |||||||
QN2. Exposure to passive smoking |
0.574
| |||||||
QN3. Drinking more than 1 unit of alcohol a day |
0.521
| |||||||
QN4. Eating less than 5 portions of fruit and vegetables a day |
0.535
| |||||||
QN5. Eating red or processed meat once a day or more |
0.483
| |||||||
QN6. Being obese |
0.537
| |||||||
QN7. Getting sunburnt more than once as a child |
0.442
| |||||||
QN8. Being over 70 years old |
0.428
| |||||||
QN9. Having a close relative with cancer |
0.349
| |||||||
QN10. Infection with HPV, Human Papillomavirus |
0.468
| |||||||
QN11. Not doing much physical activity |
0.583
| |||||||
QN12. Using a solarium |
0.439
| |||||||
QN13. Exposure to ionising radiation from, for example, radioactive materials, x-rays or radon |
0.406
|
Hypotheses testing
Group 1 Blue-collar workers (n = 16) | Group 2 Non-medical academics (n = 21) | Group 3 GP’s and oncologists (n = 19) |
p-valuea
| ||||
---|---|---|---|---|---|---|---|
% | (n) | % | (n) | % | (n) | ||
Hypothesis: Group 2 > group 1 | |||||||
Awareness of unexplained bleeding | 81.3 | (13) | 61.9 | (13) | - | - | 0.285 |
Hypothesis: Group 2 > group 1 | |||||||
Being too busy to make time to go to the doctorb
| 12.5 | (2) | 47.6 | (10) | - | - |
0.035
|
Hypothesis: Group 2 > group 1 | |||||||
Awareness of having a close relative with cancerc
| 62.5 | (10) | 81.0 | (17) | - | - | 0.274 |
Hypothesis: Group 2 > group 1 | |||||||
Awareness of getting sunburnt more than once as a childc
| 56.3 | (9) | 71.4 | (15) | 0.489 | ||
Hypothesis: Group 3 > group 2 | |||||||
Awareness of a sore that does not heal | - | - | 52.4 | (11) | 100 | (19) |
0.001
|
Hypothesis: Group 3 > group 2 | |||||||
Correctly identifying the 5-year survival from ovarian cancerd
| - | - | 9.5 | (2) | 57.9 | (11) |
0.002
|
Hypothesis: Group 3 > group 2 | |||||||
Correctly identifying that cancer risk is higher in people aged 70-years than at a younger age | - | - | 71.4 | (15) | 94.7 | (18) | 0.095 |
Hypothesis: Group 3 > group 2 | |||||||
Awareness of infection with human papillomavirus (HPV) c
| - | - | 47.6 | (10) | 100 | (19) |
0.000
|
Test-retest reliability
N
| Agreement (%) | Expected agreement (%) | Kappa | ICC (95% CI) | |
---|---|---|---|---|---|
Anticipated patient interval for healthcare seeking | |||||
Response options: I would go as soon as I noticed; up to 1 week; over 1 up to 2 weeks; over 2 up to 3 weeks; over 3 up to 4 weeks; more than a month; I would go to another healthcare professional; I would not contact my doctor. | |||||
Q5. A persistent cough | 119 | 95.6 | 87.3 | 0.65 | |
Q6. Rectal bleeding | 120 | 98.5 | 92.7 | 0.80 | |
Q7. Any breast changesb
| 75 | 95.4 | 92.0 | 0.43 | |
Q8. Abdominal bloating | 115 | 94.2 | 80.4 | 0.70 | |
Awareness of cancer symptoms | |||||
Response options: yes and no. | |||||
Q9. Unexplained lump or swelling | 122 | 90.2 | 87.7 | 0.20 | |
Q10. Persistent unexplained pain | 116 | 77.6 | 62.3 | 0.41 | |
Q11. Unexplained bleeding | 116 | 88.8 | 78.1 | 0.49 | |
Q12. Persistent cough or hoarseness | 119 | 84.9 | 63.9 | 0.58 | |
Q13. Change in bowel or bladder habits | 118 | 88.1 | 68.6 | 0.62 | |
Q14. Persistent difficulty in swallowing | 117 | 90.6 | 67.9 | 0.71 | |
Q15. Change in the appearance of a mole | 123 | 98.4 | 98.4 | −0.01 | |
Q16. Sore that does not heal | 107 | 82.2 | 65.4 | 0.49 | |
Q17. Unexplained night sweats | 100 | 81.0 | 63.4 | 0.48 | |
Q18. Unexplained weight loss | 119 | 95.0 | 84.6 | 0.67 | |
Q19. Unexplained tiredness | 115 | 86.1 | 65.0 | 0.60 | |
The total score of cancer symptom awareness | 123 | - | - | - | 0.80 (0.72–0.86) |
Anticipated barriers for healthcare seeking | |||||
Response options: yes, often; yes, sometimes; no. | |||||
Q24. I would be too embarrassed | 123 | 98.0 | 92.6 | 0.72 | |
Q25. I would be worried about wasting the doctor’s time | 123 | 98.0 | 91.0 | 0.77 | |
Q26. I would be worried about what the doctor might find | 123 | 95.9 | 88.0 | 0.66 | |
Q27. I am too busy to make time to go to the doctor | 123 | 96.3 | 87.7 | 0.70 | |
Beliefs about cancer | |||||
Response options: strongly disagree; tend to disagree; tend to agree; strongly agree. | |||||
Q28. People with cancer can expect to continue with normal activities | 119 | 93.2 | 88.2 | 0.42 | |
Q29. Most cancer treatment is worse than the cancer itself | 103 | 93.3 | 81.0 | 0.65 | |
Q30. Not want to know if I have cancer | 122 | 96.7 | 94.3 | 0.43 | |
Q31. Cancer can often be cured | 123 | 94.2 | 90.9 | 0.37 | |
Q32. Going to the doctor as quickly as possible could increase the chances of surviving | 122 | 95.7 | 93.2 | 0.37 | |
Q33. A diagnosis of cancer is a death sentence | 122 | 91.3 | 84.5 | 0.44 | |
Awareness of 5-year survival from cancer | |||||
Response options: 0; 1; 2; 3; 4; 5; 6; 7; 8; 9; 10. | |||||
Q34. Out of 10 people diagnosed with bowel cancer, how many do you think would be alive 5 years later? | 112 | 96.2 | 93.5 | 0.42 | |
Q35. Out of 10 people diagnosed with breast cancer, how many do you think would be alive 5 years later? | 120 | 96.7 | 91.7 | 0.60 | |
Q36. Out of 10 people diagnosed with ovarian cancer, how many do you think would be alive 5 years later? | 109 | 97.5 | 90.2 | 0.74 | |
Q37. Out of 10 people diagnosed with lung cancer, how many do you think would be alive 5 years later? | 120 | 97.8 | 92.7 | 0.70 | |
Breast cancer screening behaviourb
| |||||
Response options: yes; no. | |||||
QM1. Breast cancer screening behavior | 38 | 97.4 | 75.2 | 0.89 | |
Bowel cancer screening behaviourc
| |||||
Response options: yes; no. | |||||
QM2. Bowel cancer screening behavior | 68 | 100 | 83.9 | 1 | |
Beliefs about breast cancer screeninga
| |||||
Response options: strongly disagree; tend to disagree; tend to agree; strongly agree. | |||||
QM3. So worried about what might be found at breast cancer screening, that I would prefer not to do it | 75 | 98.4 | 95.2 | 0.66 | |
QM4. Breast cancer screening is only necessary if I have symptoms | 75 | 92.4 | 78.0 | 0.66 | |
QM5. Breast cancer screening could reduce my chances of dying from breast cancer | 74 | 96.7 | 87.9 | 0.73 | |
Beliefs about bowel cancer screening | |||||
Response options: strongly disagree; tend to disagree; tend to agree; strongly agree. | |||||
QM6. So worried about what might be found at bowel cancer screening, that I would prefer not to do it | 121 | 97.0 | 95.1 | 0.38 | |
QM7. Bowel cancer screening is only necessary if I have symptoms | 116 | 87.9 | 70.8 | 0.59 | |
QM8. Bowel cancer screening could reduce my chances of dying from bowel cancer | 115 | 92.8 | 88.6 | 0.36 | |
Awareness of growing risk of cancer with age | |||||
Response options: 30 year olds; 50 year olds; 70 year olds; people of any age are equally likely to be diagnosed with cancer. | |||||
Q38. Growing risk of cancer with age | 123 | 96.5 | 83.5 | 0.79 | |
Awareness of risk factors for cancer | |||||
Response options: strongly disagree; tend to disagree; tend to agree; strongly agree. | |||||
QN1. Smoking | 123 | 98.0 | 94.8 | 0.62 | |
QN2. Exposure to passive smoking | 122 | 97.5 | 89.5 | 0.76 | |
QN3. Drinking more than 1 unit of alcohol a day | 118 | 90.9 | 81.6 | 0.50 | |
QN4. Eating less than 5 portions of fruit and vegetables a day | 117 | 90.1 | 80.1 | 0.55 | |
QN5. Eating red or processed meat once a day or more | 109 | 91.0 | 80.5 | 0.54 | |
QN6. Being obese | 117 | 93.1 | 81.1 | 0.63 | |
QN7. Getting sunburnt more than once as a child | 120 | 92.5 | 79.0 | 0.64 | |
QN8. Being over 70 years old | 121 | 90.4 | 77.3 | 0.57 | |
QN9. Having a close relative with cancer | 119 | 92.1 | 82.0 | 0.56 | |
QN10. Infection with HPV, Human Papillomavirus | 37 | 95.2 | 87.3 | 0.62 | |
QN11. Not doing much physical activity | 120 | 93.8 | 83.7 | 0.62 | |
QN12. Using a solarium | 122 | 97.5 | 94.3 | 0.57 | |
QN13. Exposure to ionising radiation from, for example, radioactive materials, x-rays or radon | 119 | 95.7 | 91.6 | 0.49 | |
The total score of cancer symptom awareness | 121 | - | - | - | 0.75 (0.67–0.82) |
Self or someone close with cancer | |||||
Response options: yes, respondent; yes, someone close; yes, both self and someone close; yes, but would prefer not to say who; no. | |||||
Q3. Self or someone close with cancer | 123 | 93.5 | 58.4 | 0.84 | |
Self-rated health | |||||
Response options: very good; good; fair; poor; very poor. | |||||
Q20. Self-rated health | 123 | 97.8 | 92.2 | 0.71 | |
Access to a doctor | |||||
Response options: very difficult; somewhat difficult; somewhat easy; very easy. | |||||
Q21. Access to a doctor | 122 | 97.7 | 92.4 | 0.70 | |
Smoking behavior | |||||
Response options: yes; no. | |||||
Q22. Current smoker | 123 | 100 | 73.9 | 1.00 | |
Q23. Former smoker | 104 | 94.2 | 50.0 | 0.88 |