Abstract
BackgroundWe examined associations between different chronic morbidities and help-seeking for possible cancer symptoms.MethodsPostal survey of individuals aged >50 years in England. Participants could report prior morbidities in respect of 12 pre-defined conditions. Among patients experiencing possible cancer symptoms we examined associations between specific morbidities and self-reported help-seeking (i.e. contacted versus not contacted a GP) for each alarm symptom using regression analyses.ResultsAmong 2042 respondents (42% response rate), 936 (46%) recently experienced 1 of 14 possible cancer symptoms considered in our analysis. Of them, 80% reported one or more morbidities, most frequently hypertension/hypercholesterolemia (40%), osteomuscular (36%) and heart diseases (21%). After adjustment for socio-demographic characteristics, patients with hypertension/hypercholesterolemia were more likely to report help-seeking for possible cancer symptoms, such as unexplained cough (OR = 2.0; 95% confidence interval (CI) 1.1–3.5), pain (OR = 2.2; 95% CI 1.0–4.5) and abdominal bloating (OR = 2.3; 95% CI 1.1–4.8). Urinary morbidity was associated with increased help-seeking for abdominal bloating (OR = 5.4; 95% CI 1.2–23.7) or rectal bleeding (OR = 5.8; 95% CI 1.4–23.8). In contrast, heart problems reduced help-seeking for change in bowel habits (OR = 0.4; 95% CI 0.2–1.0).ConclusionsComorbidities are common and may facilitate help-seeking for possible cancer symptoms, but associations vary for specific symptom-comorbidity pairs. The findings can contribute to the design of future cancer symptom awareness campaigns.
Highlights
Chronic conditions affect large proportions of older individuals
After adjustment for socio-demographic characteristics, patients with hypertension/hypercholesterolemia were more likely to report help-seeking for possible cancer symptoms, such as unexplained cough (OR = 2.0; 95% confidence interval (CI) 1.1–3.5), pain (OR = 2.2; 95% CI 1.0–4.5) and abdominal bloating (OR = 2.3; 95% CI 1.1–4.8)
Comorbidities are common and may facilitate help-seeking for possible cancer symptoms, but associations vary for specific symptom-comorbidity pairs
Summary
Chronic conditions affect large proportions of older individuals. Data from both Scotland and England indicate that about half of the general population have a long-standing health condition, of whom half have two or more morbidities.[1,2] As older age is associated with both a higher prevalence of chronic diseases and higher cancer risk, it is important to examine the likely influence of pre-existing morbidities (hereafter called comorbidities) on help-seeking behavior for new symptoms that may relate to cancer. Sometimes patients might feel that help-seeking for vague symptoms is only appropriate if the Theodosia Salika, Research Assistant Georgios Lyratzopoulos, Clinical Reader in Public Health Katriina L. We examined associations between different chronic morbidities and help-seeking for possible cancer symptoms
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