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British Journal of General Practice

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Research

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

Katriina L Whitaker, Una Macleod, Kelly Winstanley, Suzanne E Scott and Jane Wardle
British Journal of General Practice 2015; 65 (631): e96-e105. DOI: https://doi.org/10.3399/bjgp15X683533
Katriina L Whitaker
School of Health Sciences, University of Surrey, Guildford.
Roles: Senior lecturer
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Una Macleod
Hull York Medical School, Hull.
Roles: Professor of primary care medicine
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Kelly Winstanley
Health Behaviour Research Centre, University College London, London.
Roles: Research associate
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Suzanne E Scott
Unit of Social and Behavioural Sciences, King’s College London Dental Institute, London.
Roles: Senior lecturer
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Jane Wardle
Health Behaviour Research Centre, University College London, London.
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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.

  • ‘alarm’ symptoms
  • awareness
  • cancer
  • fear
  • general practice
  • help-seeking
  • Received June 17, 2014.
  • Revision requested July 23, 2014.
  • Accepted August 20, 2014.
  • © British Journal of General Practice 2015

This is an OpenAccess article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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British Journal of General Practice: 65 (631)
British Journal of General Practice
Vol. 65, Issue 631
February 2015
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Help seeking for cancer ‘alarm’ symptoms: a qualitative interview study of primary care patients in the UK
Katriina L Whitaker, Una Macleod, Kelly Winstanley, Suzanne E Scott, Jane Wardle
British Journal of General Practice 2015; 65 (631): e96-e105. DOI: 10.3399/bjgp15X683533

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Help seeking for cancer ‘alarm’ symptoms: a qualitative interview study of primary care patients in the UK
Katriina L Whitaker, Una Macleod, Kelly Winstanley, Suzanne E Scott, Jane Wardle
British Journal of General Practice 2015; 65 (631): e96-e105. DOI: 10.3399/bjgp15X683533
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Keywords

  • ‘alarm’ symptoms
  • awareness
  • cancer
  • fear
  • general practice
  • help-seeking

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