Nobody likes a crybaby, as the saying goes. The British, in particular, embody restrained emotions in the face of adversity; they know how to "Keep Calm & Carry On.”
But new research in the British Journal of Cancer suggests the stereotypical British “stiff upper lip” may actually be putting the British people at risk of delayed cancer diagnosis, because they may have a greater tendency to delay seeking treatment, and avoid discussing bothersome symptoms with their doctors.
In a news brief on the study, BBC News online health editor Michelle Roberts reported that after surveying almost 20,000 adults in five high-income countries (Australia, Canada, Denmark, Norway, and Sweden) plus the UK (England, Wales, and Northern Ireland, but not Scotland), the investigators found UK adults were more reluctant than people from the other countries to seek medical help -- even though they were just as aware of the symptoms and warning signs of cancer.
The study, led by public health expert Lindsay Forbes, MD, Clinical Senior Lecturer in Health Services Research, King’s College London (KCL), also found that one-third of the UK respondents said they were worried about wasting a doctor’s time, and one in six UK men and women 50 years of age and older said they were embarrassed about sharing their symptoms with a doctor.
“This is a real UK phenomenon. UK people really stood out in our study,” Dr. Forbes told TheONC, going on to say:
As a nation, we are much more likely than people in similar high-income countries to say that we might not go to the doctor because we are embarrassed or worried that we will waste the doctor's time. It may be that we are more stoic and have a war-time mentality. It’s important that we work out why older people, who are at the highest risk of cancer, think that they might be wasting their doctor’s time and encourage them to have the confidence to seek help promptly. It could make a real difference to their chances of survival.
Dr. Forbes and co-authors noted that such stoicism and reticence to see the doctor in a timely way may account in part for cancer survival in the UK ranking below that of the other nations in the study (though survival data for Denmark is also troubling), even though patients in the UK have access to skilled medical staff and up-to-date treatments.
A large study of cancer survival in the same countries studied in the current report, and funded by Cancer Research UK and England’s Department of Health, was published by the International Cancer Benchmarking Partnership in The Lancet in 2010; it showed poorer cancer survival trends in the UK and Denmark that were “consistent with later diagnosis or differences in treatment.”
Dr. Forbes is co-director (with Amanda Ramirez) of KCL’s Promoting Early Presentation Group, whose research focuses on strategies that may boost cancer awareness and early presentation to improve survival. Co-investigators on the current study are from University College London, with help from the charity Cancer Research UK and the London-based market research company Ipsos MORI.
Sara Hiom, director of information at Cancer Research UK, told the BBC that her organization is working with other groups “to understand and address these potential barriers to early presentation and encourage people to tell their doctor if they have noticed something different about their body,” adding that another obstacle to be addressed is “the poor awareness that cancer risk increases with age.”
I think there are very good lessons to be learned from this study “across the pond.”
What do you think? What are your experiences with patients who ignored symptoms so long that their cancer was in a very serious state? Do you have tips for encouraging people you care about to get to the doctor, pronto?