Katharine A Rendle1, Elizabeth A Sarma2, Samantha L Quaife3, Kelly D Blake4, Richard P Moser4, Jerry M Suls4, Heather M Edwards4, Sarah C Kobrin5. 1. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: katharine.rendle@uphs.upenn.edu. 2. Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland. 3. Department of Behavioral Science and Health, University College London, London, England. 4. Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland. 5. Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Abstract
INTRODUCTION: Early stage diagnosis strongly predicts cancer survival. Recognition of potential symptoms of cancer may improve survival by reducing time to seeking care. METHODS: Telephone interviews with a population-representative sample of English-speaking adults (aged ≥50 years) in the U.S. (N=1,425) were conducted in 2014 using an instrument adapted from the International Cancer Benchmarking Partnership Awareness and Beliefs about Cancer survey. Anticipated time to seeking care for four cancer symptoms (persistent cough, rectal bleeding, mole changes, and breast changes) was assessed, and delay was defined as waiting >2 weeks. Recognition of symptoms as potential cancer signs was assessed dichotomously. Multivariate logistic regression models were used to assess associations between symptom recognition and anticipated delay, adjusting for demographics, cancer experience, self-reported health, and healthcare access. Analyses were weighted and conducted in 2017. RESULTS: Symptom recognition varied but was relatively high across all symptoms (76.9%-95.5%). Anticipated delay varied by symptom and was highest for persistent cough (41.2%) and lowest for rectal bleeding (9.1%). For rectal bleeding (AOR=2.65, 95% CI=1.31, 5.36) and mole changes (AOR=3.30, 95% CI=1.48, 7.33), anticipated delay was more likely among individuals who did not recognize the symptom as a warning sign. Adults with lower education levels (p<0.05) and African Americans (p<0.05) were less likely to delay for some symptoms. CONCLUSIONS: Lack of symptom recognition was associated with anticipated delay in seeking care for some cancer symptoms. Differences in recognition and delays by symptom could be driven partly by screening messaging or by ambiguity and functional impact of each symptom.
INTRODUCTION: Early stage diagnosis strongly predicts cancer survival. Recognition of potential symptoms of cancer may improve survival by reducing time to seeking care. METHODS: Telephone interviews with a population-representative sample of English-speaking adults (aged ≥50 years) in the U.S. (N=1,425) were conducted in 2014 using an instrument adapted from the International Cancer Benchmarking Partnership Awareness and Beliefs about Cancer survey. Anticipated time to seeking care for four cancer symptoms (persistent cough, rectal bleeding, mole changes, and breast changes) was assessed, and delay was defined as waiting >2 weeks. Recognition of symptoms as potential cancer signs was assessed dichotomously. Multivariate logistic regression models were used to assess associations between symptom recognition and anticipated delay, adjusting for demographics, cancer experience, self-reported health, and healthcare access. Analyses were weighted and conducted in 2017. RESULTS: Symptom recognition varied but was relatively high across all symptoms (76.9%-95.5%). Anticipated delay varied by symptom and was highest for persistent cough (41.2%) and lowest for rectal bleeding (9.1%). For rectal bleeding (AOR=2.65, 95% CI=1.31, 5.36) and mole changes (AOR=3.30, 95% CI=1.48, 7.33), anticipated delay was more likely among individuals who did not recognize the symptom as a warning sign. Adults with lower education levels (p<0.05) and African Americans (p<0.05) were less likely to delay for some symptoms. CONCLUSIONS: Lack of symptom recognition was associated with anticipated delay in seeking care for some cancer symptoms. Differences in recognition and delays by symptom could be driven partly by screening messaging or by ambiguity and functional impact of each symptom.
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
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