title: Knowledge of cancer symptoms and anxiety affect patient delay in seeking diagnosis in patients with heterogeneous cancer locations.
abstract: This research was aimed at identifying factors that predict patient delay in treatment initiation in patients with suspected cancer disease. We sought to determine the differences between delaying and nondelaying patients with reference to their knowledge of cancer symptoms, sociodemographic variables, and the levels of state anxiety and trait anxiety.
  
  
  
  The study involved 301 randomly selected patients with suspected cancer disease before their first oncology appointment at a regional oncology center in Poland. Data were collected by means of a semistructured interview conducted by a trained psychologist. To evaluate the knowledge of cancer symptoms, the symptoms mentioned by subjects were compared to the list of symptoms from cancer awareness measure. Anxiety levels were assessed using the State-Trait Anxiety Inventory.
  
  
  
  In the course of logistic regression analysis a model was developed, in which knowledge of cancer symptoms and state anxiety allowed to predict patient delay. Knowledge of every additional cancer symptom decreased the chance of patient delay by 16.4% point [95% CI: 1.4-29.2]. An increase in state anxiety for every point of the scale decreased the chance of delay by 2.5% points [95% CI: 0.2-4.6]. Trait anxiety and the studied sociodemographic variables proved to be nonsignificant predictors of patient delay.
  
  
  
  Knowledge of cancer symptoms and the level of state anxiety allowed to predict patient delay in the initiation of treatment. Owing to the heterogeneity of the tumor locations within the sample, the obtained model can be used in large scale prevention programs designed for the whole population.
authors.affiliation: Psychology Department, University of Finance and Management, Warsaw, Poland.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Chojnacka-Szawłowska
authors.affiliation: Department of Quality of Life Research, Medical University of Gdansk, Gdañsk, Poland; Public Health Department, Pomeranian University in Słupsk, Słupsk, Poland.
authors.forename: Mikołaj
authors.initials: M
authors.lastname: Majkowicz
authors.affiliation: Department of Quality of Life Research, Medical University of Gdansk, Gdañsk, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Basiński
authors.affiliation: Department of Quality of Life Research, Medical University of Gdansk, Gdañsk, Poland. Electronic address: azdun@gumed.edu.pl.
authors.forename: Agata
authors.initials: A
authors.lastname: Zdun-Ryżewska
authors.affiliation: Postgraduate Studies Clinical Psychooncology, Medical University of Gdansk, Gdañsk, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Wasilewko
authors.affiliation: Clinic of Adult Psychiatry, Medical University of Gdansk, Gdañsk Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Pankiewicz
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D057210:Delayed Diagnosis / Q000523:psychology* / Q000706:statistics & numerical data*; D059026:Diagnostic Self Evaluation; D055088:Early Detection of Cancer / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors
keywords: Anxiety; Cancer; Delayed diagnosis; Symptoms