title: Recognition of cancer warning signs and anticipated delay in help-seeking in a population sample of adults in the UK.
abstract: BACKGROUND
  Not recognising a symptom as suspicious is a common reason given by cancer patients for delayed help-seeking; but inevitably this is retrospective. We therefore investigated associations between recognition of warning signs for breast, colorectal and lung cancer and anticipated time to help-seeking for symptoms of each cancer.
  
  
  METHODS
  Computer-assisted telephone interviews were conducted with a population-representative sample (N=6965) of UK adults age ≥ 50 years, using the Awareness and Beliefs about Cancer scale. Anticipated time to help-seeking for persistent cough, rectal bleeding and breast changes was categorised as >2 vs ≤ 2 weeks. Recognition of persistent cough, unexplained bleeding and unexplained lump as cancer warning signs was assessed (yes/no). Associations between recognition and help-seeking were examined for each symptom controlling for demographics and perceived ease of health-care access.
  
  
  RESULTS
  For each symptom, the odds of waiting for >2 weeks were significantly increased in those who did not recognise the related warning sign: breast changes: OR=2.45, 95% CI 1.47-4.08; rectal bleeding: OR=1.77, 1.36-2.30; persistent cough: OR=1.30, 1.17-1.46, independent of demographics and health-care access.
  
  
  CONCLUSIONS
  Recognition of warning signs was associated with anticipating faster help-seeking for potential symptoms of cancer. Strategies to improve recognition are likely to facilitate earlier diagnosis.
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
authors.forename: S L
authors.initials: SL
authors.lastname: Quaife
authors.affiliation: King's College London Promoting Early Presentation Group, King's College London, London SE1 3QD, UK.
authors.forename: L J L
authors.initials: LJ
authors.lastname: Forbes
authors.affiliation: King's College London Promoting Early Presentation Group, King's College London, London SE1 3QD, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Ramirez
authors.affiliation: Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff CF14 4YS, UK.
authors.forename: K E
authors.initials: KE
authors.lastname: Brain
authors.affiliation: Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland BT12 6DP, UK.
authors.forename: C
authors.initials: C
authors.lastname: Donnelly
authors.affiliation: Health Services Research, School of Health Sciences, City University London, London EC1V 0HB, UK.
authors.forename: A E
authors.initials: AE
authors.lastname: Simon
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
authors.forename: J
authors.initials: J
authors.lastname: Wardle
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D055088:Early Detection of Cancer; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology