title: What prompts help-seeking for cancer 'alarm' symptoms? A primary care based survey.
abstract: BACKGROUND
  Encouraging prompt help-seeking for cancer symptoms can help shorten the patient interval and improve timely diagnosis. We explored factors associated with help-seeking in a primary care sample reporting 'alarm' symptoms.
  
  
  METHODS
  A questionnaire was mailed to 9771 adults (⩾ 50 years of age and no cancer diagnosis) and 3766 (39%) returned it. Our sample included 1732 adults reporting at least one cancer 'alarm' symptom; with a total of 2726 symptoms. Respondents completed questions relating to help-seeking, demographic and symptom characteristics (e.g., type, knowledge, concern, interference and attribution).
  
  
  RESULTS
  Over a third of people who reported a cancer 'alarm' symptom in the past 3 months had not sought help from a doctor. An unexplained lump (odds ratio (OR) 2.46, 1.42-4.26) and persistent unexplained pain (OR 1.79, 1.19-2.69) were associated with increased likelihood of help-seeking. Symptom concern (OR 3.10, 2.19-4.39) and interference (OR 3.06, 2.15-4.36) were associated with an increased likelihood of seeking help independently of symptom type. People who were not working (OR 1.41, 1.09-1.83), were married/cohabiting rather than single (OR 1.38, 1.10-1.74) and were older (60-69 years) rather than younger (50-59 years; OR 1.33, 1.02-1.75) were more likely to have sought help.
  
  
  CONCLUSIONS
  Our findings highlighted symptom type and symptom characteristics as key drivers of help-seeking. We also found that there may be specific demographic groups where encouraging help-seeking might be warranted.
authors.affiliation: School of Health Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK.
authors.forename: K L
authors.initials: KL
authors.lastname: Whitaker
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
authors.forename: C Friedemann
authors.initials: CF
authors.lastname: Smith
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
authors.forename: K
authors.initials: K
authors.lastname: Winstanley
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: D000367:Age Factors; D000368:Aged; D057210:Delayed Diagnosis; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000523:psychology / Q000706:statistics & numerical data