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Ethnic differences in cancer symptom awareness and barriers to seeking medical help in England
Authors:Maja Niksic  Bernard Rachet  Fiona G Warburton  Lindsay J L Forbes
Affiliation:1Cancer Epidemiology and Population Health, Division of Cancer Studies, King''s College London, Bermondsey Wing, Guy''s Hospital, Great Maze Pond, London SE1 9RT, UK;2Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Abstract:

Background:

Ethnic differences in cancer symptom awareness and barriers to seeking medical help in the English population are not fully understood. We aimed to quantify these differences, to help develop more effective health campaigns, tailored to the needs of different ethnic groups.

Methods:

Using a large national data set (n=38 492) of cross-sectional surveys that used the Cancer Research UK Cancer Awareness Measure, we examined how cancer symptom awareness and barriers varied by ethnicity, controlling for socio-economic position, age and gender. Data were analysed using multivariable logistic regression.

Results:

Awareness of cancer symptoms was lower in minority ethnic groups than White participants, with the lowest awareness observed among Bangladeshis and Black Africans. Ethnic minorities were more likely than White British to report barriers to help-seeking. South Asians reported the highest emotional barriers, such as lack of confidence to talk to the doctor, and practical barriers, such as worry about many other things. The Irish were more likely than the White British to report practical barriers, such as being too busy to visit a doctor. White British participants were more likely than any other ethnic group to report that they would feel worried about wasting the doctor''s time. Overall, Black Africans had the lowest barriers. All differences were statistically significant (P<0.01 level), after controlling for confounders.

Conclusions:

Our findings suggest the need for culturally sensitive and targeted health campaigns, focused on improving recognition of cancer symptoms among ethnic minorities. Campaigns should tackle the specific barriers prevalent in each ethnic group.
Keywords:ethnicity   cancer awareness   barriers   help-seeking behaviour   social inequality   England
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