“It still feels like a death thing”: What is the place of primary care in fostering public understandings of cancer?

Problem

In terms of morbidity and mortality, cancer remains one of the UK’s biggest health problems. Because of this, there has been considerable focus from policymakers and charitable bodies alike on raising awareness of cancer symptoms among the lay-public. Whilst awareness of symptoms for different cancers does seem to have filtered through to some areas of the public domain, the perception of cancer as a ‘death sentence’ has not been fully dispelled. The problem is to understand why, despite the continued efforts of campaign organisers to promote the advantages of early symptom detection on survival rates for some cancers, the term ‘cancer’ itself retains a powerfully negative status within the consciousness of the public.

Approach

We are conducting a series of focus groups and semi-structured interviews in a northern city of the UK with higher than average cancer mortality rates. Participants are members of the public who have not been diagnosed with cancer. The study sample is a mixed cohort with regard to gender, age and socio-economic status. Our inquiry focuses on participants’ awareness of cancer symptoms, their understandings of cancer risk and cause, their perceptions of awareness campaigns, and their experiences of help-seeking and consequent behaviour.

Findings

Although data collection is ongoing, our initial findings demonstrate a distinction across the study sample with regard to cancer and mortality between participants who perceive cancer as an ‘umbrella term’ for a multiplicity of cancers with a range of symptoms and outcomes, and participants who perceive cancer as a singular and random disease that can strike anyone at any time, regardless of whether symptoms are detected early or late, and where death from cancer is the inevitable outcome. Across the study sample, the majority of participants’ so far have exhibited a spectrum of these latter perceptions. What is of interest is that such responses are regardless of participants’ experiences of family members/friends who have survived different cancers. We suggest that campaign messages emphasising the importance of earlier detection for some cancers are being masked by lay interpretations of statistics such as ‘one in two people in the UK will get cancer’.

Consequences

Raising awareness that continues to emphasise the positive impact earlier detection can have on treatment and survival of some cancers should continue. However, there is also a need to explore other strategies that might dispel notions of cancer as an inevitable ‘death sentence’. As GPs are promoted through campaigns as the first port of call for people with worrying symptoms, it would seem sensible to focus attention on how a more nuanced understanding of different cancers might be fostered at a primary care level.