Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Although a cancer diagnosis is linked with decrements to quality of life (QoL), it is unknown exactly when QoL starts to deteriorate, and whether this occurs during the pre-diagnostic pathway. This study aimed to examine QoL during this phase, and in addition investigate whether QoL levels influence decisions about seeking professional help. This is important, because early diagnosis is linked to lower cancer mortality rates.
Working alongside a Cancer Research UK Roadshow in socially deprived communities, the recent QoL of adult visitors was assessed, before attending primary care. Using a cross-sectional design, we compared QoL in those presenting a potential cancer symptom/sign, with others seeking lifestyle advice to reduce cancer risk. Self-reported QoL (WHOQOL-BREF), and intention to seek help, were measured.
Of 107 recruited, 50% were men. The potential cancer symptom group reported significantly poorer general QoL and psychological QoL, than lifestyle controls. Prior poorer physical QoL predicted stronger intentions to consult a general practitioner (GP) in the next 2 weeks, when controlling for symptom presence.
QoL is poorer for those with potential cancer symptoms, before they first seek advice from primary care. Poorer physical QoL is associated with stronger intentions to make a GP appointment. An implication for longer term health is that if public awareness about the impact of symptoms on QoL was raised, this could provide an impetus to seek help.
Walter, F., Webster, A., Scott, S., & Emery, J. (2012). The Andersen model of total patient delay: A systematic review of its application in cancer diagnosis. Journal of Health Services Research & Policy, 17(2), 110–118. CrossRef
Heo, S., Doering, L., Widener, J., & Moser, D. (2008). Predictors and effect of physical symptom status on health-related quality of life in patients with heart failure. American Journal of Critical Care, 17(2), 124–132. PubMed
Merkus, M., Jager, K., Dekker, F., de Haan, R., Boeschoten, E., Krediet, R., et al. (1999). Physical symptoms and quality of life in patients on chronic dialysis: Results of The Netherlands Cooperative Study on Adequacy of Dialysis (NECOSAD). Nephrology Dialysis Transplantation, 14(5), 1163–1170. CrossRef
The WHOQOL Group. (1994). The development of the World Health Organisation Quality of Life Assessment Instrument (the WHOQOL). In J. Orley & W. Kuyken (Eds.), Quality of life assessment: International perspectives. Heidelberg: Springer.
Aaronson, N., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N., et al. (1993). The European organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376. CrossRefPubMed
Skevington, S., & Epton, T. (2018). How will the sustainable development goals deliver changes in wellbeing? A systematic review and meta-analysis to investigate whether WHOQOL-BREF scores respond to change. British Medical Journal Global Health. https://doi.org/10.1136/bmjgh-2017-000609. CrossRef
Zikos, E., Coens, C., Quinten, C., Ediebah, D., Martinelli, F., Ghislain, I., et al. (2016). The added value of analyzing pooled health-related quality of life data: A review of the EORTC PROBE initiative. Journal of the National Cancer Institute, 108(5), 1–8. CrossRef
Katsinelos, P., Lazaraki, G., Kountouras, J., Paroutoglou, G., Oikonomidou, I., Mimidis, K., et al. (2009). Prevalence, bowel habit subtypes and medical care-seeking behaviour of patients with irritable bowel syndrome in Northern Greece. European Journal of Gastroenterology & Hepatology, 21(2), 183–189. CrossRef
Kroenke, K., Spitzer, R., & Williams, J. (2003). The Patient Health Questionnaire-2: Validity of a two-item depression screener. Medical Care, 41(11), 1284–1292. CrossRef
Tabachnick, B., & Fidell, L. (2006). Using multivariate statistics (5th edn.). Boston: Pearson.
Montazeri, A. (2008). Health-related quality of life in breast cancer patients: A bibliographic review of the literature from 1974 to 2007. Journal of Experimental & Clinical Cancer Research, 29, 27–32.
Llewellyn, A., & Skevington, S. (2015). Using guided individualised feedback to review self-reported quality of life in health and its importance. Psychology & Health, 30(3), 301–317. CrossRef
Organisation for Economic Co-operation and Development (2014). Education at a Glance. Accessed 13 March, 2017, from https://www.oecd.org/edu/Education-at-a-Glance-2014.pdf.
Office of National Statistics. (2016). UK labour market. Accessed 13 March, 2017, from https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/bulletins/uklabourmarket/november2016.
Ellis, L., Rachet, B., Shah, A., Walters, S., Coleman, M., Cooper, N., et al. (2009). Trends in cancer survival in Spearhead Primary Care Trusts in England, 1998–2004. Health Statistics Quarterly, 41, 7–12. CrossRef
Lee, C., & Owens, R. (2002). The psychology of men’s health. Buckingham: Open University Press.
- Undiagnosed cancer symptoms in the community: does poor quality of life influence the decision to seek help?
Suzanne M. Skevington
- Springer International Publishing