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PUBLIC RELEASE DATE:
29-Jan-2013

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Contact: Seil Collins
seil.collins@kcl.ac.uk
44-207-848-5377
King's College London
@kingscollegelon

British 'stiff upper lip' may prevent early presentation for cancer symptoms

Embarrassment and not wanting to waste their doctors' time are more frequently reported by British people than in other countries, according to new research led jointly by King's College London and UCL (University College London). This may be holding British people back from presenting early with symptoms of cancer.

The international study, published today in the British Journal of Cancer, is the largest of its kind, and suggests that cultural factors such as the British 'stiff upper lip' may help explain some of the differences in cancer survival rates between the UK and other high-income countries.

The study is part of the International Cancer Benchmarking Partnership (ICBP), a unique global collaboration, which has previously found that for lung, breast, bowel and ovary cancers diagnosed in between 1995 and 2007, Australia, Canada, Sweden and Norway had the highest rates of survival, and Denmark and UK the lowest, despite all the countries having similarly good cancer registration systems and good access to health care. For example, one year survival of those diagnosed with lung cancer between 2005 and 2007 for the UK was 30% compared to 44% in Sweden. The researchers therefore wanted to find out whether survival rates for a country might be influenced by the population's cancer awareness and beliefs.

In partnership with Cancer Research UK and Ipsos MORI, the team surveyed 19,079 men and women aged 50 and older in Australia (4,002 individuals), Canada (2,064), Denmark (2,000), Norway (2,009), Sweden (2,039) and the UK (6,965).

The researchers found there was little difference in awareness of cancer symptoms and beliefs about cancer outcomes between the countries. However, the study revealed significant differences in people's barriers to symptomatic presentation. Being worried about wasting the doctor's time was particularly common in the UK (34%) and least common in Sweden (9%). Embarrassment about going to the doctor with a symptom that might be serious was most commonly reported in the UK (15%) and least in Denmark (6%). The study also found that awareness of the risk of cancer being higher in older people varied significantly across countries, being lowest in Canada (13%) and the UK (14%) and highest in Sweden (38%).

Dr Lindsay Forbes from King's College London and joint lead author of the study says: "The UK stood out in this study. A high proportion of people said that not wanting to waste the doctor's time and embarrassment might stop them going to the doctor with a symptom that might be serious. The traditional British 'stiff upper lip' could be preventing people from seeing their doctor. We need to support people to make the right decisions about their health and increase awareness of the age-related risk."

Professor Jane Wardle, from UCL adds: "In the UK, it's important to understand more about how people make the decision to go to their GP with possible cancer symptoms, and how they interact with their GP, to identify the best ways to reduce barriers to early presentation."

Sara Hiom, Director of Patient Engagement and Early Diagnosis at Cancer Research UK says: "It's encouraging to see that people in the UK know as much about cancer symptoms as people in Australia, Canada or Scandinavia, and that overall, people surveyed had generally positive beliefs about cancer outcomes. But the research highlights that people in the UK are more worried and embarrassed about seeing their doctor with a symptom that might be serious compared to those in other countries. Cancer Research UK and others are working hard to understand and address these potential barriers to early presentation and encourage people to tell their doctor if they have noticed something different about their body. More work also needs to be done to tackle the poor awareness that cancer risk increases with age."

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Notes to editors:

For a copy of the paper or interview with the author, please contact Seil Collins, Press Officer, King's College London, Institute of Psychiatry
Email: seil.collins@kcl.ac.uk
Tel: (+44) 0207 848 5377 or mob: (+44) 07718 697 176

Paper reference: Forbes, L. et al. 'Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival?' British Journal of Cancer

Technical note: Ipsos MORI conducted 19,079 computer assisted telephone interviews between May 2011 and September 2011 among people aged 50+ in Australia (two states: New South Wales and Victoria), Canada (four provinces: Alberta, British Columbia, Manitoba, Ontario), Denmark, Sweden (two areas Uppsala-Orebro, Stockholm-Gotland), Norway and the UK (England, Wales, Northern Ireland). This age group was selected because population-level cancer survival largely reflects survival in the over 50s, in whom cancer is the commonest. Cancer awareness and beliefs were measured using the newly developed 'Awareness and beliefs about cancer measure'. Results were weighted to the known demographic profiles within each country.

Funding: The study was funded by the UK's Department of Health, with additional funding from the National Cancer Action Team (UK), Northern Ireland Public Health Agency (UK), Tenovus and Welsh Government (UK), Cancer Council Victoria (Australia), Department of Health Victoria (Australia), Cancer Institute New South Wales (Australia), Canadian Partnership against Cancer, Danish Cancer Society, Novo Nordic Foundation (Denmark), Norwegian Directorate for Health and Social Affairs, Swedish Social Ministry and the Association of Local Authorities and Regions (Sweden).

Programme management was provided by Cancer Research UK.

About the International Cancer Benchmarking Partnership (ICBP):

The International Cancer Benchmarking Partnership (ICBP) is a unique and innovative global partnership of clinicians, academics and policymakers. The ICBP is funded by the UK Department of Health and Cancer Research UK. http://www.cancerresearchuk.org/cancer-info/spotcancerearly/ICBP/

About the British Journal of Cancer (BJC):

The BJC is owned by Cancer Research UK. Its mission is to encourage communication of the very best cancer research from laboratories and clinics in all countries. Broad coverage, its editorial independence and consistent high standards have made BJC one of the world's premier general cancer journals. www.bjcancer.com

About King's College London:

King's College London is one of the top 30 universities in the world (2012/13 QS international world rankings), and was The Sunday Times 'University of the Year 2010/11', and the fourth oldest in England. A research-led university based in the heart of London, King's has more than 24,000 students (of whom more than 10,000 are graduate students) from nearly 140 countries, and more than 6,100 employees. King's is in the second phase of a £1 billion redevelopment programme which is transforming its estate.

King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £525 million (year ending 31 July 2011).

King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar.

King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: www.kingshealthpartners.org.

The College is in the midst of a five-year, £500 million fundraising campaign - World questions|King's answers - created to address some of the most pressing challenges facing humanity as quickly as feasible. The campaign's five priority areas are neuroscience and mental health, leadership and society, cancer, global power and children's health. More information about the campaign is available at www.kcl.ac.uk/kingsanswers.

About UCL (University College London):

Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender and the first to provide systematic teaching of law, architecture and medicine.

We are among the world's top universities, as reflected by our performance in a range of international rankings and tables. According to the Thomson Scientific Citation Index, UCL is the second most highly cited European university and the 15th most highly cited in the world.

UCL has nearly 25,000 students from 150 countries and more than 9,000 employees, of whom one third are from outside the UK. The university is based in Bloomsbury in the heart of London, but also has two international campuses - UCL Australia and UCL Qatar. Our annual income is more than £800 million.

www.ucl.ac.uk | Follow us on Twitter @uclnews | Watch our YouTube channel YouTube.com/UCLTV

About Cancer Research UK:

Cancer Research UK is the world's leading cancer charity dedicated to saving lives through research

The charity's pioneering work into the prevention, diagnosis and treatment of cancer has helped save millions of lives.

Cancer Research UK receives no government funding for its life-saving research. Every step it makes towards beating cancer relies on every pound donated.

Cancer Research UK has been at the heart of the progress that has already seen survival rates in the UK double in the last forty years.

Cancer Research UK supports research into all aspects of cancer through the work of over 4,000 scientists, doctors and nurses.

Together with its partners and supporters, Cancer Research UK's vision is to bring forward the day when all cancers are cured.

For further information about Cancer Research UK's work or to find out how to support the charity, please call 0300 123 1861 or visit www.cancerresearchuk.org. Follow us on Twitter and Facebook



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