BMJ Open (Sep 2021)

Cancer symptom experience and help-seeking behaviour during the COVID-19 pandemic in the UK: a cross-sectional population survey

  • Jo Waller,
  • Graham Moore,
  • Kate Brain,
  • Victoria Whitelock,
  • Rebecca Cannings-John,
  • Katriina L Whitaker,
  • Julie Hepburn,
  • Yvonne Moriarty,
  • Julia Townson,
  • Michael Robling,
  • Harriet D Quinn-Scoggins,
  • Grace M McCutchan,
  • Detelina Grozeva,
  • Jacqueline Hughes,
  • Kirstie Osborne,
  • Mark Goddard,
  • Ardiana Gjini

DOI
https://doi.org/10.1136/bmjopen-2021-053095
Journal volume & issue
Vol. 11, no. 9

Abstract

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Objectives To understand self-reported potential cancer symptom help-seeking behaviours and attitudes during the first 6 months (March–August 2020) of the UK COVID-19 pandemic.Design UK population-based survey conducted during August and September 2020. Correlates of help-seeking behaviour were modelled using logistic regression in participants reporting potential cancer symptoms during the previous 6 months. Qualitative telephone interviews with a purposeful subsample of participants, analysed thematically.Setting Online UK wide survey.Participants 7543 adults recruited via Cancer Research UK online panel provider (Dynata) and HealthWise Wales (a national register of ‘research ready’ participants) supplemented with social media (Facebook and Twitter) recruitment. 30 participants were also interviewed.Main outcome measures Survey measures included experiences of 15 potential cancer symptoms, help-seeking behaviour, barriers and prompts to help-seeking.Results Of 3025 (40.1%) participants who experienced a potential cancer symptom, 44.8% (1355/3025) had not contacted their general practitioner (GP). Odds of help-seeking were higher among participants with disability (adjusted OR (aOR)=1.38, 95% CI 1.11 to 1.71) and who experienced more symptoms (aOR=1.68, 95% CI 1.56 to 1.82), and lower among those who perceived COVID-19 as the cause of symptom(s) (aOR=0.36, 95% CI 0.25 to 0.52). Barriers included worries about wasting the doctor’s time (1158/7543, 15.4%), putting strain on healthcare services (945, 12.6%) and not wanting to make a fuss (907, 12.0%). Interviewees reported reluctance to contact the GP due to concerns about COVID-19 and fear of attending hospitals, and described putting their health concerns on hold.Conclusions Many people avoided healthcare services despite experiencing potential cancer symptoms during the COVID-19 pandemic. Alongside current help-seeking campaigns, well-timed and appropriate nationally coordinated campaigns should signal that services are open safely for those with unusual or persistent symptoms.Trial registration number ISRCTN17782018.