Does socio-demographic profile influence awareness of potential symptoms for lung or head and neck cancers in adults over 50?

Conference:

SAPC ASM 2016 - Dublin

Talk Code:

P2.07

Presenter:

Una Macleod

Co-authors:

Julie Walabyeki1, Joy Adamson2, Hannah Buckley2, Helena Sinclair1, Katriina Whitaker3, Karl Atkin2, Hilary Graham2, Una Macleod1

Author institutions:

1: Hull York Medical School, 2: Department of Health Sciences University of York, 3: University of Surrey

Problem

In terms of morbidity and mortality, cancer remains a significant health problem in the United Kingdom, which has led to significant interest in both patients and professionals recognising cancer symptoms. Some studies have argued that sociodemographic inequalities may be partly responsible for differences in when cancer is diagnosed and survival. This suggests the need for improved awareness of cancer symptoms to facilitate early diagnosis and better survival, especially in marginalised and disadvantaged groups. Although there is evidence of an association between socio-economic status (SES) and the awareness of general cancer symptoms by patients, no studies have examined differences in the awareness of respiratory or head and neck cancer symptoms among people who have not yet been diagnosed with cancer.

Approach

A survey was mailed to 3954 adults (≥50 years, no cancer diagnosis) with a symptom list including 14 respiratory and head and neck cancer symptoms. Identifying a symptom as a potential respiratory or head and neck cancer symptom was regarded as a measure of awareness for that symptom. Respondents were also asked if they had experienced any of these symptoms in the past 3 months, and if so, whether they had sought medical advice. Data were analysed using SPSS Statistics 22.0. Logistic regression, adjusting for gender, age, relationship status, education, type of accommodation, and living alone was used for analysis.

Findings

The response rate after one reminder was 30.5% (1205/3954). The mean number of symptoms recognised by all the respondents was 6.78/14 (CI: 6.52-7.04). In multivariable analysis, having no degree or formal education was the only demographic variable independently associated with lower awareness of all respiratory and head and neck cancer symptoms. After adjusting for other variables, respondents living in rented accommodation from local authorities/housing associations were more likely to have persistent cough (OR=3.14 [1.93-5.11] p<0.001) but less likely to be aware (OR=0.56 [0.36-0.88]; p=0.013) it was a potential cancer symptom when compared to those who own their houses; although there was no significant difference in help-seeking.

Consequences

The level of awareness for respiratory or head and neck cancer symptoms was significantly lower for respondents with no degree or formal education, as well as those living in social rented housing. This may impede early diagnosis of respiratory or head and neck cancers and ultimately survival for people within this socio-demographic profile. Therefore, improved symptom awareness within this group could help to reduce inequalities in diagnosis and survival for respiratory or head and neck cancers.

Submitted by:

Osaretin Oviasu

Funding acknowledgement:

We would like to acknowledge the support of the National Institute for Health Research Clinical Research Network and our funders, Cancer Research UK