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Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

What is it about a cancer diagnosis that would worry people? A population-based survey of adults in England

Authors: Philippa J. Murphy, Laura A. V. Marlow, Jo Waller, Charlotte Vrinten

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

Surveys indicate quite high prevalence of cancer worry in the general population, but little is known about what it is about cancer that worries people. A better understanding of the origins of cancer worry may help elucidate previously found inconsistencies in its behavioural effect on cancer prevention, screening uptake, and help-seeking for symptoms. In this study, we explore the prevalence and population distribution of general cancer worry and worries about specific aspects of cancer previously identified.

Methods

A population-based survey of 2048 English adults (18–70 years, April–May 2016), using face-to-face interviews to assess demographic characteristics, general cancer worry and twelve sources of cancer worry (adapted from an existing scale), including the emotional, physical, and social consequences of a diagnosis.

Results

In general, a third of respondents (37%) never worried about cancer, 57% worried occasionally/sometimes, and 6% often/very often. In terms of specific worries, two thirds would be ‘quite a bit’ or ‘extremely’ worried about the threat to life and emotional upset a diagnosis would cause. Half would worry about surgery, radiotherapy, chemotherapy, and loss of control over life. Worries about the social consequences were less commonly anticipated: just under half would worry about financial problems or their social roles, and a quarter would be worried about effects on identity, important relationships, gender role, and sexuality. Women and younger people reported more frequent worry about getting cancer, and would be more worried about the emotional, physical, and social consequences of a cancer diagnosis (p < .001). Those from ethnic minority backgrounds reported less frequent worry about getting cancer than their white counterparts, but would be equally worried about the emotional and physical impact of a cancer diagnosis, and worried more about the social consequences of a cancer diagnosis (p < .05).

Conclusions

The majority of English adults worry at least occasionally about getting cancer, and would be most worried about the emotional and physical impact of a cancer diagnosis. Distinguishing between the various worries that cancer can evoke may help inform efforts to allay undue worries in those who are deterred by them from engaging with cancer prevention and early detection.
Appendix
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Footnotes
1
In population research, the terms ‘cancer fear’ and ‘cancer worry’ are often used interchangeably. In clinical psychology, ‘fear’ refers to the emotional response to an immediate and observable threat and ‘worry’ refers to a more cognitive process where the threat is often anticipatory in nature [Rachman, S. Anxiety, 2nd ed. Hove: Psychology Press; 2004]. Consistent with these definitions, we will use the term ‘cancer worry’ to describe the negative emotional reaction to the threat of cancer in an asymptomatic population, except when referring to previous studies, where we will use the term that is used by the authors.
 
Literature
1.
go back to reference Ferrer RA, Portnoy DB, Klein WM. Worry and risk perceptions as independent and interacting predictors of health protective behaviors. J Health Commun. 2013;18:397–409.CrossRefPubMed Ferrer RA, Portnoy DB, Klein WM. Worry and risk perceptions as independent and interacting predictors of health protective behaviors. J Health Commun. 2013;18:397–409.CrossRefPubMed
2.
go back to reference Persoskie A, Ferrer RA, Klein WM. Association of cancer worry and perceived risk with doctor avoidance: an analysis of information avoidance in a nationally representative US sample. J Behav Med. 2014;37:977–87.CrossRefPubMed Persoskie A, Ferrer RA, Klein WM. Association of cancer worry and perceived risk with doctor avoidance: an analysis of information avoidance in a nationally representative US sample. J Behav Med. 2014;37:977–87.CrossRefPubMed
3.
go back to reference Vrinten C, Waller J, Von Wagner C, Wardle J. Cancer fear: facilitator and deterrent to participation in colorectal cancer screening. Cancer Epidemiol Biomark Prev. 2015;24:400–5.CrossRef Vrinten C, Waller J, Von Wagner C, Wardle J. Cancer fear: facilitator and deterrent to participation in colorectal cancer screening. Cancer Epidemiol Biomark Prev. 2015;24:400–5.CrossRef
4.
go back to reference Hay JL, Buckley TR, Ostroff JS. The role of cancer worry in cancer screening: a theoretical and empirical review of the literature. Psychooncology. 2005;14:517–34.CrossRefPubMed Hay JL, Buckley TR, Ostroff JS. The role of cancer worry in cancer screening: a theoretical and empirical review of the literature. Psychooncology. 2005;14:517–34.CrossRefPubMed
5.
go back to reference Lerman C, Rimer BK, Daly M, Lustbader E, Sands C, Balshem A, Masny A, Engstrom P. Recruiting high risk women into a breast cancer health promotion trial. Cancer Epidemiol Biomark Prev. 1994;3:271–6. Lerman C, Rimer BK, Daly M, Lustbader E, Sands C, Balshem A, Masny A, Engstrom P. Recruiting high risk women into a breast cancer health promotion trial. Cancer Epidemiol Biomark Prev. 1994;3:271–6.
6.
go back to reference McCaul KD, Schroeder DM, Reid PA. Breast cancer worry and screening: some prospective data. Health Psychol. 1996;15:430–3.CrossRefPubMed McCaul KD, Schroeder DM, Reid PA. Breast cancer worry and screening: some prospective data. Health Psychol. 1996;15:430–3.CrossRefPubMed
7.
go back to reference Moser RP, McCaul K, Peters E, Nelson W, Marcus SE. Associations of perceived risk and worry with cancer health-protective actions data from the health information National Trends Survey (HINTS). J Health Psychol. 2007;12:53–65.CrossRefPubMed Moser RP, McCaul K, Peters E, Nelson W, Marcus SE. Associations of perceived risk and worry with cancer health-protective actions data from the health information National Trends Survey (HINTS). J Health Psychol. 2007;12:53–65.CrossRefPubMed
8.
go back to reference Gramling R, Anthony D, Frierson G, Bowen D. The cancer worry chart: a single-item screening measure of worry about developing breast cancer. Psychooncology. 2007;16:593–7.CrossRefPubMed Gramling R, Anthony D, Frierson G, Bowen D. The cancer worry chart: a single-item screening measure of worry about developing breast cancer. Psychooncology. 2007;16:593–7.CrossRefPubMed
9.
go back to reference Champion VL, Skinner CS, Menon U, Rawl S, Giesler RB, Monahan P, Daggy J. A breast cancer fear scale: psychometric development. J Health Psychol. 2004;9:753–62.CrossRefPubMed Champion VL, Skinner CS, Menon U, Rawl S, Giesler RB, Monahan P, Daggy J. A breast cancer fear scale: psychometric development. J Health Psychol. 2004;9:753–62.CrossRefPubMed
10.
go back to reference Hay JL, McCaul KD, Magnan RE. Does worry about breast cancer predict screening behaviors? A meta-analysis of the prospective evidence. Prev Med. 2006;42:401–8.CrossRefPubMed Hay JL, McCaul KD, Magnan RE. Does worry about breast cancer predict screening behaviors? A meta-analysis of the prospective evidence. Prev Med. 2006;42:401–8.CrossRefPubMed
11.
go back to reference Balasooriya-Smeekens C, Walter FM, Scott S. The role of emotions in time to presentation for symptoms suggestive of cancer: a systematic literature review of quantitative studies. Psychooncology. 2015;24:1594–604.CrossRefPubMed Balasooriya-Smeekens C, Walter FM, Scott S. The role of emotions in time to presentation for symptoms suggestive of cancer: a systematic literature review of quantitative studies. Psychooncology. 2015;24:1594–604.CrossRefPubMed
12.
go back to reference Dubayova T, van Dijk JP, Nagyova I, Rosenberger J, Havlikova E, Gdovinova Z, Middel B, Groothoff JW. The impact of the intensity of fear on patient's delay regarding health care seeking behavior: a systematic review. Int J Public Health. 2010;55:459–68.CrossRefPubMedPubMedCentral Dubayova T, van Dijk JP, Nagyova I, Rosenberger J, Havlikova E, Gdovinova Z, Middel B, Groothoff JW. The impact of the intensity of fear on patient's delay regarding health care seeking behavior: a systematic review. Int J Public Health. 2010;55:459–68.CrossRefPubMedPubMedCentral
13.
go back to reference Consedine NS, Magai C, Krivoshekova YS, Ryzewicz L, Neugut I. Fear, anxiety, worry, and breast screening behavior: a critical review. Cancer Epidemiol Biomark Prev. 2004;13:501–10. Consedine NS, Magai C, Krivoshekova YS, Ryzewicz L, Neugut I. Fear, anxiety, worry, and breast screening behavior: a critical review. Cancer Epidemiol Biomark Prev. 2004;13:501–10.
14.
go back to reference Witte K. Putting the fear back into fear appeals: the extended parallel process model. Commun Monogr. 1992;59:329–49.CrossRef Witte K. Putting the fear back into fear appeals: the extended parallel process model. Commun Monogr. 1992;59:329–49.CrossRef
15.
go back to reference Rogers RW. Cognitive and physiological processes in fear appeals and attitude change: a revised theory of protection motivation. In: Cacioppo JT, Petty RE (eds). Social Psychophysiology: a sourcebook. GuilfordPublications; 1983. Rogers RW. Cognitive and physiological processes in fear appeals and attitude change: a revised theory of protection motivation. In: Cacioppo JT, Petty RE (eds). Social Psychophysiology: a sourcebook. GuilfordPublications; 1983.
16.
go back to reference Consedine NS, Adjei BA, Ramirez PM, McKiernan JM. An object lesson: source determines the relations that trait anxiety, prostate cancer worry, and screening fear hold with prostate screening frequency. Cancer Epidemiol Biomark Prev. 2008;17:1631–9.CrossRef Consedine NS, Adjei BA, Ramirez PM, McKiernan JM. An object lesson: source determines the relations that trait anxiety, prostate cancer worry, and screening fear hold with prostate screening frequency. Cancer Epidemiol Biomark Prev. 2008;17:1631–9.CrossRef
17.
go back to reference Ahmad AS, Ormiston-Smith N, Sasieni PD. Trends in the lifetime risk of developing cancer in great Britain: comparison of risk for those born from 1930 to 1960. Br J Cancer. 2015;112:943–7.CrossRefPubMedPubMedCentral Ahmad AS, Ormiston-Smith N, Sasieni PD. Trends in the lifetime risk of developing cancer in great Britain: comparison of risk for those born from 1930 to 1960. Br J Cancer. 2015;112:943–7.CrossRefPubMedPubMedCentral
18.
go back to reference Herschbach P, Berg P, Dankert A, Duran G, Engst-Hastreiter U, Waadt S, Keller M, Ukat R, Henrich G. Fear of progression in chronic diseases: psychometric properties of the fear of progression questionnaire. J Psychosom Res. 2005;58:505–11.CrossRefPubMed Herschbach P, Berg P, Dankert A, Duran G, Engst-Hastreiter U, Waadt S, Keller M, Ukat R, Henrich G. Fear of progression in chronic diseases: psychometric properties of the fear of progression questionnaire. J Psychosom Res. 2005;58:505–11.CrossRefPubMed
19.
go back to reference Simard S, Savard J. Fear of cancer recurrence inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence. Support Care Cancer. 2008;17:241–51.CrossRefPubMed Simard S, Savard J. Fear of cancer recurrence inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence. Support Care Cancer. 2008;17:241–51.CrossRefPubMed
20.
go back to reference Vickberg SMJ. The concerns about recurrence scale (CARS): a systematic measure of women’s fears about the possibility of breast cancer recurrence. Ann Behav Med. 2003;25:16–24.CrossRefPubMed Vickberg SMJ. The concerns about recurrence scale (CARS): a systematic measure of women’s fears about the possibility of breast cancer recurrence. Ann Behav Med. 2003;25:16–24.CrossRefPubMed
21.
go back to reference Facione NC. Delay versus help seeking for breast cancer symptoms: a critical review of the literature on patient and provider delay. Soc Sci Med. 1993;36:1521–34.CrossRefPubMed Facione NC. Delay versus help seeking for breast cancer symptoms: a critical review of the literature on patient and provider delay. Soc Sci Med. 1993;36:1521–34.CrossRefPubMed
22.
go back to reference Smith LK, Pope C, Botha JL. Patients’ help-seeking experiences and delay in cancer presentation: a qualitative synthesis. Lancet. 2005;366:825–31.CrossRefPubMed Smith LK, Pope C, Botha JL. Patients’ help-seeking experiences and delay in cancer presentation: a qualitative synthesis. Lancet. 2005;366:825–31.CrossRefPubMed
23.
go back to reference Vrinten C, McGregor LM, Heinrich M, Wagner C, Waller J, Wardle J, Black GB. What do people fear about cancer? A systematic review and meta-synthesis of cancer fears in the general population. Psychooncology. 2016; E-pub 19 September 2016. Vrinten C, McGregor LM, Heinrich M, Wagner C, Waller J, Wardle J, Black GB. What do people fear about cancer? A systematic review and meta-synthesis of cancer fears in the general population. Psychooncology. 2016; E-pub 19 September 2016.
25.
go back to reference Han PK, Moser RP, Klein WM. Perceived ambiguity about cancer prevention recommendations: associations with cancer-related perceptions and behaviours in a US population survey. Health Expect. 2007;10:321–36.CrossRefPubMedPubMedCentral Han PK, Moser RP, Klein WM. Perceived ambiguity about cancer prevention recommendations: associations with cancer-related perceptions and behaviours in a US population survey. Health Expect. 2007;10:321–36.CrossRefPubMedPubMedCentral
26.
go back to reference McQueen A, Vernon SW, Meissner HI, Rakowski W. Risk perceptions and worry about cancer: does gender make a difference? J Health Commun. 2008;13:56–79.CrossRefPubMed McQueen A, Vernon SW, Meissner HI, Rakowski W. Risk perceptions and worry about cancer: does gender make a difference? J Health Commun. 2008;13:56–79.CrossRefPubMed
27.
28.
go back to reference McCaul KD, Branstetter AD, O’Donnell SM, Jacobson K, Quinlan KB. A descriptive study of breast cancer worry. J Behav Med. 1998;21:565–79.CrossRefPubMed McCaul KD, Branstetter AD, O’Donnell SM, Jacobson K, Quinlan KB. A descriptive study of breast cancer worry. J Behav Med. 1998;21:565–79.CrossRefPubMed
29.
go back to reference Andersen MR, Smith R, Meischke H, Bowen D, Urban N. Breast cancer worry and mammography use by women with and without a family history in a population-based sample. Cancer Epidemiol Biomark Prev. 2003;12:314–20. Andersen MR, Smith R, Meischke H, Bowen D, Urban N. Breast cancer worry and mammography use by women with and without a family history in a population-based sample. Cancer Epidemiol Biomark Prev. 2003;12:314–20.
31.
go back to reference Sutton S, Bickler G, Sancho-Aldridge J, Saidi G. Prospective study of predictors of attendance for breast screening in inner London. J Epidemiol Commun Health. 1994;48:65–73.CrossRef Sutton S, Bickler G, Sancho-Aldridge J, Saidi G. Prospective study of predictors of attendance for breast screening in inner London. J Epidemiol Commun Health. 1994;48:65–73.CrossRef
32.
go back to reference Consedine NS, Magai C, Neugut AI. The contribution of emotional characteristics to breast cancer screening among women from six ethnic groups. Prev Med. 2004;38:64–77.CrossRefPubMed Consedine NS, Magai C, Neugut AI. The contribution of emotional characteristics to breast cancer screening among women from six ethnic groups. Prev Med. 2004;38:64–77.CrossRefPubMed
33.
go back to reference McLean CP, Anderson ER. Brave men and timid women? A review of gender differences in fear and anxiety. Clin Psychol Rev. 2009;29:496–505.CrossRefPubMed McLean CP, Anderson ER. Brave men and timid women? A review of gender differences in fear and anxiety. Clin Psychol Rev. 2009;29:496–505.CrossRefPubMed
34.
go back to reference Wong PT, Reker GT, Gesser G. Death attitude profile-revised: a multidimensional measure of attitude toward death. In: Niemeyer R, editor. Death anxiety handbook: research, instrumentation, and application. Washington, DC: Taylor & Francis; 1994. p. 121–48. Wong PT, Reker GT, Gesser G. Death attitude profile-revised: a multidimensional measure of attitude toward death. In: Niemeyer R, editor. Death anxiety handbook: research, instrumentation, and application. Washington, DC: Taylor & Francis; 1994. p. 121–48.
35.
go back to reference Vrinten C, Wardle J. Is cancer a good way to die? A population-based survey among middle-aged and older adults in the United Kingdom. Eur J Cancer. 2016;56:172–8.CrossRefPubMedPubMedCentral Vrinten C, Wardle J. Is cancer a good way to die? A population-based survey among middle-aged and older adults in the United Kingdom. Eur J Cancer. 2016;56:172–8.CrossRefPubMedPubMedCentral
36.
37.
go back to reference Moser RP, Arndt J, Han PK, Waters EA, Amsellem M, Hesse BW. Perceptions of cancer as a death sentence: prevalence and consequences. J Health Psychol. 2014;19:1518–24.CrossRefPubMed Moser RP, Arndt J, Han PK, Waters EA, Amsellem M, Hesse BW. Perceptions of cancer as a death sentence: prevalence and consequences. J Health Psychol. 2014;19:1518–24.CrossRefPubMed
38.
go back to reference Quaife SL, Winstanley K, Robb KA, Simon AE, Ramirez AJ, Forbes LJ, Brain KE, Gavin A, Wardle J. Socioeconomic inequalities in attitudes towards cancer: an international cancer benchmarking partnership study. Eur J Cancer Prev. 2015;24:253–60.CrossRefPubMedPubMedCentral Quaife SL, Winstanley K, Robb KA, Simon AE, Ramirez AJ, Forbes LJ, Brain KE, Gavin A, Wardle J. Socioeconomic inequalities in attitudes towards cancer: an international cancer benchmarking partnership study. Eur J Cancer Prev. 2015;24:253–60.CrossRefPubMedPubMedCentral
39.
go back to reference Kale HP, Carroll NV. Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors. Cancer. 2016;122:283–9.CrossRefPubMed Kale HP, Carroll NV. Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors. Cancer. 2016;122:283–9.CrossRefPubMed
40.
go back to reference Marlow LA, Waller J, Wardle J. Barriers to cervical cancer screening among ethnic minority women: a qualitative study. J Fam Plan Reprod Health Care. 2015;41:248–54.CrossRef Marlow LA, Waller J, Wardle J. Barriers to cervical cancer screening among ethnic minority women: a qualitative study. J Fam Plan Reprod Health Care. 2015;41:248–54.CrossRef
41.
42.
go back to reference Robb KA, Solarin I, Power E, Atkin W, Wardle J. Attitudes to colorectal cancer screening among ethnic minority groups in the UK. BMC Public Health. 2008;8:34.CrossRefPubMedPubMedCentral Robb KA, Solarin I, Power E, Atkin W, Wardle J. Attitudes to colorectal cancer screening among ethnic minority groups in the UK. BMC Public Health. 2008;8:34.CrossRefPubMedPubMedCentral
43.
go back to reference Moser K, Patnick J, Beral V. Inequalities in reported use of breast and cervical screening in great Britain: analysis of cross sectional survey data. BMJ. 2009;338:b2025.CrossRefPubMedPubMedCentral Moser K, Patnick J, Beral V. Inequalities in reported use of breast and cervical screening in great Britain: analysis of cross sectional survey data. BMJ. 2009;338:b2025.CrossRefPubMedPubMedCentral
44.
go back to reference Szczepura A, Price C, Gumber A. Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics. BMC Public Health. 2008;8:346.CrossRefPubMedPubMedCentral Szczepura A, Price C, Gumber A. Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics. BMC Public Health. 2008;8:346.CrossRefPubMedPubMedCentral
45.
go back to reference Von Wagner C, Baio G, Raine R, Snowball J, Morris S, Atkin W, Obichere A, Handley G, Logan RF, Rainbow S. Inequalities in participation in an organized national colorectal cancer screening programme: results from the first 2.6 million invitations in England. Int J Epidemiol. 2011;40:712–8.CrossRefPubMed Von Wagner C, Baio G, Raine R, Snowball J, Morris S, Atkin W, Obichere A, Handley G, Logan RF, Rainbow S. Inequalities in participation in an organized national colorectal cancer screening programme: results from the first 2.6 million invitations in England. Int J Epidemiol. 2011;40:712–8.CrossRefPubMed
46.
go back to reference Macleod U, Mitchell ED, Burgess C, Macdonald S, Ramirez AJ. Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer. 2009;101(Suppl 2):S92–S101.CrossRefPubMedPubMedCentral Macleod U, Mitchell ED, Burgess C, Macdonald S, Ramirez AJ. Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer. 2009;101(Suppl 2):S92–S101.CrossRefPubMedPubMedCentral
Metadata
Title
What is it about a cancer diagnosis that would worry people? A population-based survey of adults in England
Authors
Philippa J. Murphy
Laura A. V. Marlow
Jo Waller
Charlotte Vrinten
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3963-4

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