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Britain’s stiff upper lip 'increases cancer risk'

Having a traditional “stiff upper lip” could be putting Britons in mortal danger from cancer, researchers claim.

A study by international experts suggests that British stoicism may help explain differences in cancer survival between the UK and other high-income countries.

People in Britain were said to be more likely than others to avoid bothering their doctor or nurse over symptoms they find embarrassing and time-wasting.

As a result, cancer sufferers were less likely to be treated at an early stage when there is a greater chance of survival.

Dr Lindsay Forbes, from King’s College London, one of the lead authors of the research published in the British Journal of Cancer, said: “The UK stood out in this study. A high proportion of people said that not wanting to waste the doctor’s time and embarrassment might stop them going to the doctor with a symptom that might be serious.

“The traditional British “stiff upper lip” could be preventing people from seeing their doctor.”

The scientists, from a collaboration called the International Cancer Benchmarking Partnership, previously compared cancer survival in a number of developed countries, including the UK.

For lung, breast, bowel and ovarian cancers diagnosed between 1995 and 2007, Australia, Canada, Sweden and Norway had the best survival rates.

Denmark and the UK had the lowest, despite all the countries having similarly good cancer registration systems and access to health care.

One year, survival for people with lung cancer was 30% in the UK compared with 44% in Sweden.

The new study, jointly conducted with the charity Cancer Research UK and pollsters Ipsos Mori, set out to learn whether cultural factors could explain the differences.

Researchers surveyed 19,079 men and women aged 50 and older in the six countries.

They found little difference across borders in people’s awareness of cancer symptoms and their views about the chances of surviving the disease.

But when the scientists looked at barriers to seeing the doctor with early cancer symptoms, British reserve came to the fore.

Being worried about wasting a doctor’s time was especially common in the UK, where it was reported by 34% of those surveyed. In contrast, just 9% of Swedes were concerned about time-wasting in the surgery.

Embarrassment about going to the doctor with a potentially serious symptom was most common in Britain (15%) and least common in Denmark (6%).

However, ignorance also had a part to play. Awareness that cancer risk increased with age was lowest in Canada (13%) and the UK (14%) and highest in Sweden (38%).

Dr Forbes said: “We need to support people to make the right decisions about their health and increase awareness of the age-related risk.”

Professor Jane Wardle, from University College London, said: “In the UK, it’s important to understand more about how people make the decision to go to their GP with possible cancer symptoms, and how they interact with their GP, to identify the best ways to reduce barriers to early presentation.”

Sara Hiom, director of patient engagement and early diagnosis at Cancer Research UK, said it was encouraging that Britons appeared to be knowledgeable about cancer symptoms and had positive beliefs about cancer outcomes.

But she added: “The research highlights that people in the UK are more worried and embarrassed about seeing their doctor with a symptom that might be serious compared to those in other countries.

 

 

Readers' comments (4)

  • The news that Britain lags behind other countries in cancer survival rates highlights the need for an integrated healthcare model to improve the way in which individuals with or at risk of such long term conditions are managed.

    The research indicates that one of the reasons behind poor survival rates is late diagnosis, which is reported to be down to a patient’s reluctance to visit their GP due to a fear of time wasting or embarrassment. This is however, not the complete picture. It is equally as likely, if not more so, that individuals will not seek clinical advice because they have little or no idea of what the support networks are if they are diagnosed.

    This fear means that it becomes all too easy for someone to incorrectly self-diagnose based on a previous experience or explain away what might be a telling symptom for a medically trained professional.

    This is where health coaching can make a huge difference. For individuals diagnosed with a particular long-term condition, health coaching - where registered nurses help the patient manage their condition by providing mentoring and support via two-way phone calls - is emerging as a powerful platform to nurture informed patients and help them overcome fears, embarrassment and better manage their long-term conditions.

    For example, with security and anonymity in the arms’ length, yet trusted relationship, patients are more likely to mention that they have noticed blood in their stool or a small lump in their breast. Using the correct, non-directive, terminology, the health coach can then suggest that “your GP would want to know about that because there are a number of reasons for that to be happening and it’s important to confirm the cause so that you can be given any necessary treatment ,” which could provide the necessary spur a patient needs to help early diagnosis and improved chances of recovery.

    Health coaching has been shown to motivate patients towards a readiness to change unhelpful thinking patterns. It can facilitate patients’ confidence and skills in self-management, and help them prepare for consultations, particularly in this instance by providing them with the confidence to know they would not be wasting the doctor’s time, proactively consider treatment options and encourage behavioural change. Moreover, with patients conscious that consultation time with their GP is limited, health coaching provides a valuable opportunity for individuals to discuss the longer-term management and implications of their condition with a trained health practitioner – providing that ongoing support patients need as they seek to adapt their lifestyles.

    As Britons we have good access to skilled medical staff and cutting-edge treatments; it is therefore critical that the support tools and services are also in place to support individuals in all aspects of their care.

    Clare Wexler,
    CEO, Totally Health
    www.totallyhealth.com

    Unsuitable or offensive?

  • Maybe people are reluctant to go to their GP because they aren't taken seriously or are fobbed off with "it's nothing to worry about, come back and see me in a few weeks if it doesn't get better".
    Be interesting to know the misdiagnosis or missed diagnosis rate of cancer amongst GP's.
    It sometimes takes several persistent visits to the GP for the patient to be taken seriously, if indeed they ever are.
    If we are educating people about the early signs of cancer and encouraging people to see their doctor then the GP's need to get their act together and listen well to the history and investigate properly. Better to be safe than sorry would be my motto.

    Unsuitable or offensive?

  • Anonymous | 5-Feb-2013 8:50 am

    "Be interesting to know the misdiagnosis or missed diagnosis rate of cancer amongst GP's."

    something which requires urgent investigation.

    surveys should be carried out of patients experience with their GPs for what ever reason. there are too many complaints.

    isn't it time we got rid of this archaic gate keeper practice of GPs and let patients choose who they wish to consult like in most other civilised countries of the world.

    Unsuitable or offensive?

  • Maybe people are reluctant to go to their GP because they aren't taken seriously or are fobbed off with "it's nothing to worry about, come back and see me in a few weeks if it doesn't get better".
    Be interesting to know the misdiagnosis or missed diagnosis rate of cancer amongst GP's.
    It sometimes takes several persistent visits to the GP for the patient to be taken seriously, if indeed they ever are.
    If we are educating people about the early signs of cancer and encouraging people to see their doctor then the GP's need to get their act together and listen well to the history and investigate properly. Better to be safe than sorry would be my motto.

    Unsuitable or offensive?

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