Hilary Davies1, Afrodita Marcu1, Peter Vedsted2, Katriina L Whitaker1. 1. School of Health Sciences, University of Surrey, Guildford, UK. 2. Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care (CaP), Faculty of Health, Aarhus University, Aarhus, Denmark.
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- to 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 (eg, comorbidities and healthcare system factors).
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- to 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 (eg, comorbidities and healthcare system factors).
Authors: Daniel Jones; Erica Di Martino; Stephen H Bradley; Blessing Essang; Scott Hemphill; Judy M Wright; Cristina Renzi; Claire Surr; Andrew Clegg; Richard Neal Journal: Br J Gen Pract Date: 2022-06-16 Impact factor: 6.302
Authors: Luís Carlos Lopes-Júnior; Larissa Soares Dell'Antonio; Raphael Manhaes Pessanha; Cristiano Soares Dell'Antonio; Michelaine Isabel da Silva; Thayna Mamedi de Souza; Jonathan Grassi Journal: Int J Environ Res Public Health Date: 2022-09-22 Impact factor: 4.614
Authors: José Revilla-López; Andrea Anampa-Guzmán; Luis Casanova Marquez; Katrina Weeks; Suzanne Pollard; Adriel Olórtegui-Yzú; María Ruiz-Velazco; Alba Davila-Edquen; Daniel Castro-Dorer; Juan Wong-Barrenechea; Jossira Abad-Seminario; Pamela Gonzáles-Ramos; Fiorella Rivera-Sandoval; Carlos Carracedo-Gonzáles Journal: Infect Agent Cancer Date: 2019-11-29 Impact factor: 2.965