Socioeconomic Disparities in Beliefs about Cancer: Irish National Cancer Awareness Survey

Abstract

Abstract For most tumour types survival varies according to socioeconomic position (SEP) and stage at diagnosis. The aim of this study was to examine the association between SEP and beliefs about cancer, and the impact of beliefs on symptom awareness and help-seeking. This is important as negative beliefs about cancer may represent a modifiable target in cancer awareness campaigns aimed at adults aged 50+ years. A cross-sectional study of 1,327 adults aged 50+ years was conducted using data from the Irish National Cancer Awareness Survey, 2022. SEP was indexed using educational attainment. Beliefs about cancer were assessed using the Awareness and Beliefs about Cancer measure, symptom awareness using the Cancer Awareness Measure, and help-seeking using the French Cancer Barometer. Latent Clas Analysis (LCA) was used to identify unobserved ‘beliefs about cancer’ subgroups across belief items. Multivariable logistic regression, adjusted for age, sex, smoking status and cancer experience, was then used to identify associations between SEP and belief subgroups, and subsequently between belief subgroups and symptom awareness and anticipated help-seeking. LCA identified two subgroups: n = 1,033 (77.7%) broadly positive and n = 294 (22.3%) broadly negative. Those with primary education or less, and those with secondary education, were more likely to endorse negative beliefs relative to those with tertiary education (aOR 3.20 (95%CI 1.84, 5.53;p<0.001) and aOR 1.88(95%CI 1.32, 2.70;p<0.001) respectively). Compared to the positive beliefs subgroup, the negative subgroup were less aware of persistent cough as a potential cancer symptom (aOR 0.60(95%CI 0.40, 0.88);p=0.01) and less likely to anticipate seeing a doctor first with symptoms (aOR 1.52 (95%CI 1.11, 2.08;p=0.009) ‘other’ vs. ‘doctor’). Negative beliefs about cancer are associated with lower SEP. Negative beliefs about cancer should be targeted in health promotion campaigns seeking to increase awareness and help-seeking behaviour. Key messages • There is a need for interventions to increase symptom awareness and encourage timely help-seeking in those with symptoms suggestive of cancer particularly among socioeconomically disadvantaged groups. • Negative beliefs about cancer should be targeted in health promotion campaigns seeking to increase awareness and help-seeking behaviour.