People still dismiss cancer alarm symptoms

People still dismiss cancer alarm symptoms

Only a tiny proportion of those who had experienced any of the ‘alarm’ symptoms realised they could be caused by cancer, despite extensive public awareness campaigns aimed at improving early diagnosis. Experts are calling for new ways to encourage people to see their GP quickly about worrying symptoms, as lead study author Dr Katriina Whitaker, senior research fellow at University College London, warned: “People could delay seeing a doctor if they don’t acknowledge cancer as a possible cause.”

Researchers in London and Hull posted a questionnaire to 4,858 adults (≥50 years old, with no cancer diagnosis) through three general practices in London; they had valid responses from just over a third (35% – 1724 people). The questionnaire asked people about their symptom experiences over the past three months, without mentioning the word cancer: what they thought had caused their symptoms; how serious they considered the symptoms to be; and whether or not they had seen a doctor about them.


Ten ‘alarm’ symptoms, which have been widely publicised as being possibly caused by cancer – such as unexplained cough, bleeding, unexplained lump, changes in a mole, and a persistent change in bowel or bladder habits – were embedded in a list that included other symptoms unlikely to be cancer-related, such as headache, shortness of breath, chest pain, feeling tired or having low energy, dizziness, feeling the heart pound or race, and sore throat.


More than half (53%) of respondents said that they’d had at least one of the red-flag symptoms over the previous three months, with no differences between men and women. Overall, only 2% of these people regarded cancer as a possible cause; the highest number of cancer attributions was for an unexplained lump (7%), but change in bladder habit, persistent unexplained pain and unexplained weight loss were never attributed to cancer. Instead, people tended to blame factors including diet, advancing age, haemorrhoids, arthritis or infection.

Nearly a quarter (23%) of all alarm symptoms were seen as serious (ranging from 12% for change in the appearance of a mole, to 41% for unexplained pain). Despite this, only just over half (59%) of people who experienced these symptoms had contacted their GP about them, ranging from 47% for change in a mole to 72% for persistent unexplained pain. However, alarm symptoms did tend to be regarded as being more serious than non-alarm symptoms, and were more likely to trigger help-seeking.

The study’s authors concluded: “These results indicate that people rarely acknowledge cancer as a possible cause when they appraise their own symptoms in daily life; even symptoms for which there is high recognition in surveys of cancer knowledge. This highlights a distinction between what people know ‘in theory’ and what is accessible to them ‘in practice’.”

They went on: “Of course, the majority of people experiencing an ‘alarm’ symptom do not have cancer; nonetheless, in combination with retrospective reports of delay among cancer patients, and epidemiological evidence highlighting the potential importance of the patient interval for achieving earlier diagnosis, it is clear that opportunities for cancer to be diagnosed earlier are being missed.”


* Katriina L. Whitaker, et al. Attributions of Cancer ‘Alarm’ Symptoms in a Community Sample. PLOS ONE, 2014. DOI: 10.1371/journal.pone.0114028




By Louise Prime,


OnMedica, Wednesday 3rd December 2014




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