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Multicenter Study
. 2015 Feb;65(631):e96-e105.
doi: 10.3399/bjgp15X683533.

Help seeking for cancer 'alarm' symptoms: a qualitative interview study of primary care patients in the UK

Katriina L Whitaker  1 , Una Macleod  2 , Kelly Winstanley  3 , Suzanne E Scott  4 , Jane Wardle  3
Affiliations
Multicenter Study

Help seeking for cancer 'alarm' symptoms: a qualitative interview study of primary care patients in the UK

Katriina L Whitaker et al. Br J Gen Pract. 2015 Feb.

Abstract

Background: Delay in help seeking for cancer 'alarm' symptoms has been identified as a contributor to delayed diagnosis.

Aim: To understand people's help-seeking decision making for cancer alarm symptoms, without imposing a cancer context.

Design and setting: Community-based, qualitative interview study in the UK, using purposive sampling by sex, socioeconomic status, and prior help seeking, with framework analysis of transcripts.

Method: Interviewees (n = 48) were recruited from a community-based sample (n = 1724) of adults aged ≥50 years who completed a health survey that included a list of symptoms. Cancer was not mentioned. Participants reporting any of 10 cancer alarm symptoms (n = 915) and who had consented to contact (n = 482) formed the potential pool from which people were invited to an interview focusing on their symptom experiences.

Results: Reasons for help seeking included symptom persistence, social influence, awareness/fear of a link with cancer, and 'just instinct'. Perceiving the symptom as trivial or 'normal' was a deterrent, as was stoicism, adopting self-management strategies, and fear of investigations. Negative attitudes to help seeking were common. Participants did not want to be seen as making a fuss, did not want to waste the doctor's time, and were sometimes not confident that the GP could help.

Conclusion: Decision making about cancer alarm symptoms was complex. Recognition of cancer risk almost always motivated help seeking (more so than the fear of cancer being a deterrent), assisted by recent public-awareness campaigns. As well as symptom persistence motivating help seeking, it could also have the reverse effect. Negative attitudes to help seeking were significant deterrents.

Keywords: awareness; cancer; fear; general practice; help-seeking; ‘alarm’ symptoms.

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Figures

Figure 1.
Figure 1.
Study recruitment flowchart.
See this image and copyright information in PMC

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