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- Page navigation anchor for Socioeconomic differences in help seeking for colorectal cancer symptoms during COVID-19 - Response to Atherton et alSocioeconomic differences in help seeking for colorectal cancer symptoms during COVID-19 - Response to Atherton et al
We welcome the opportunity to respond to Atherton et al and to reassure of the methodological validity of our study:
We include details of other SES indices (included in IMD) in the supplementary file. Furthermore, the paper cited in the eLetter also states that education is a frequently used indicator of socioeconomic status because it is relevant to people regardless of age.
The symptoms we report in our paper are supported by robust sources e.g. Bowel Cancer UK., and were agreed with our co-authors, including a GP and those specialising in diagnosing and treating colorectal cancer. Our participants’ eventual diagnosis was outside scope - we were interested in how people made sense and sought help for symptoms. In doing so, this adds important information to a broader picture about how inequalities were exacerbated.
Our patient representative who sadly died was involved in the study design and early analysis discussions. Julie Callin (our other patient representative) is a co-author on the paper and was involved in the entire research process.
The recommendation regarding infection control is relevant because reticence to seek help due to fears about COVID infection was reported particularly in lower SES groups.
Finally, this study is based on patient accounts of help-seeking during the pandemic, so it is incorrect to suggest that we did not include patients from general practices. We are pleased to share that we hav...
Show MoreCompeting Interests: None declared. - Page navigation anchor for Socioeconomic differences in help seeking for colorectal cancer symptoms during COVID-19Socioeconomic differences in help seeking for colorectal cancer symptoms during COVID-19
We read with interest the paper by Ip et al. exploring socioeconomic differences in help seeking for colorectal cancer symptoms during COVID-19.1 While we agree with the importance of this topic, the study has significant weaknesses that limit its validity.
We felt it should have been clear from the title onwards that the study is about participant reported help seeking associated with educational attainment. The latter is a poor indicator of socioeconomic status,2 whereas a measure, such as the “Index of Multiple Deprivation” (IMD)3 that considers several factors that contribute to socioeconomic status would have been more appropriate.
Participant recruitment was conducted through a ‘Market Research Participant Recruitment agency’.4 The authors state that participant screening was conducted by the company based on symptoms relating to bowel cancer. However, they do not report in this paper the symptoms that the chosen participants were reported as having, the duration of these symptoms and the subsequent diagnosis (and if it was indeed bowel cancer). The only indication of their symptoms was provided in the quote captions; however, some of these were non-specific, such as “extreme tiredness”, that are not in themselves necessarily indicative of colorectal cancer. Details of the inclusion criteria that were used to identify participants should have been reported, together with a...
Show MoreCompeting Interests: None declared.