title: Cancer symptom awareness and barriers to symptomatic presentation in England--are we clear on cancer?
abstract: BACKGROUND
  Low cancer awareness may contribute to delayed diagnosis and poor cancer survival. We aimed to quantify socio-demographic differences in cancer symptom awareness and barriers to symptomatic presentation in the English population.
  
  
  METHODS
  Using a uniquely large data set (n=49 270), we examined the association of cancer symptom awareness and barriers to presentation with age, gender, marital status and socio-economic position (SEP), using logistic regression models to control for confounders.
  
  
  RESULTS
  The youngest and oldest, the single and participants with the lowest SEP recognised the fewest cancer symptoms, and reported most barriers to presentation. Recognition of nine common cancer symptoms was significantly lower, and embarrassment, fear and difficulties in arranging transport to the doctor's surgery were significantly more common in participants living in the most deprived areas than in the most affluent areas. Women were significantly more likely than men to both recognise common cancer symptoms and to report barriers. Women were much more likely compared with men to report that fear would put them off from going to the doctor.
  
  
  CONCLUSIONS
  Large and robust socio-demographic differences in recognition of some cancer symptoms, and perception of some barriers to presentation, highlight the need for targeted campaigns to encourage early presentation and improve cancer outcomes.
authors.affiliation: Promoting Early Cancer Presentation Group, King's College London, Guy's Hospital Campus, 42 Weston Street, London SE1 3QD, UK.
authors.forename: M
authors.initials: M
authors.lastname: Niksic
authors.affiliation: Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
authors.forename: B
authors.initials: B
authors.lastname: Rachet
authors.affiliation: Promoting Early Cancer Presentation Group, King's College London, Guy's Hospital Campus, 42 Weston Street, London SE1 3QD, UK.
authors.forename: F G
authors.initials: FG
authors.lastname: Warburton
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK.
authors.forename: J
authors.initials: J
authors.lastname: Wardle
authors.affiliation: Promoting Early Cancer Presentation Group, King's College London, Guy's Hospital Campus, 42 Weston Street, London SE1 3QD, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Ramirez
authors.affiliation: Promoting Early Cancer Presentation Group, King's College London, Guy's Hospital Campus, 42 Weston Street, London SE1 3QD, UK.
authors.forename: L J L
authors.initials: LJ
authors.lastname: Forbes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D003144:Communication Barriers; D004739:England / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology; D021641:Recognition, Psychology; D012959:Socioeconomic Factors; D055815:Young Adult