Psychological factors related to time to help-seeking for cancer symptoms: a meta-analysis across cancer sites

Abstract

The time patients wait before seeking help for cancer symptoms is among the most important factors contributing to diagnostic delays in cancer. We reviewed the association between time to help-seeking and three psychological factors: symptom knowledge, symptom interpretation, and beliefs about cancer (Prospero review protocol CRD42018088944). Forty-seven studies published between 1990 and 2019 met the inclusion criteria, providing data on 44,961 participants from 22 countries concerning seven cancer sites. A series of random-effects meta-analyses and meta-regressions were conducted. Better symptom knowledge was related to lower odds of a long help-seeking interval in both studies with healthy populations (OR=.73, 95% CI [.63, .84], k=19) and with patients (OR=.40, 95% CI [.23, .69], k=12), and so was interpreting experienced symptoms as cancer-related (OR=.52, 95% CI [.36, .75], k=13 studies with patients). More positive beliefs about cancer (i.e., that cancer is treatable) were associated with lower odds of a long help-seeking interval in both studies with healthy populations (OR=.70, 95% CI [.52, .92], k=11) and with patients (OR=.51, 95% CI [.32, .82], k=7). Symptom knowledge, interpretation, and beliefs about cancer are likely to be universal predictors of help-seeking. Theoretical models of patient help-seeking and interventions aiming to reduce delays should incorporate these factors.

Anticipated delay in help-seeking for cancer symptoms: Findings from a nationwide study of Malaysian adults

“…Low-and middle-income (LMICs) countries were represented, however, studies in LMICs where conducted mainly with patient-rather than healthypopulations. Findings suggested that higher income (inequality) was related to stronger protective effects in relation to cancer symptom knowledge [17]. The weak relationship between respondents with higher vs lower symptom awareness in the findings presented here may be due, partly, to the small number of participants who reported anticipated delayed help-seeking for >2 weeks for breast and colorectal cancer symptoms.…”

“…Findings from the ICBS also suggested that not recognising a symptom as a potential cancer sign was associated with an anticipated delay in help-seeking for all three symptoms; and a meta-analysis of studies from 22 different countries, which concluded that better symptom knowledge (OR=0.73, 95% CI 0.63, 0.84) and more positive beliefs about cancer (OR=0.70, 95% CI 0.52, 0.92) were associated with lower odds of a delay in help-seeking in healthy adult populations, universally [17]. Most studies were from the UK and other high-income countries.…”

“…The time it takes to seek help is often referred to as 'delayed help-seeking' [16][17][18], although there is an argument for using terms such as 'time to presentation' or 'prolonged help-seeking' that have no negative connotation [19]. From here on, we use 'delayed help-seeking' to refer to the concept of prolonged time to seeking medical help after noticing a potential cancer symptom.…”

Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

“…[11][12][13] Most research on cancer symptom appraisal and helpseeking has been conducted in HIC. In two previous systematic reviews of psychosocial influences on helpseeking for cancer symptoms, only 10% 14 and 15% 15 of studies were conducted in LMICs. Previous systematic reviews conducted in LMICs have focused on understanding barriers to help-seeking for breast or head and neck cancer using narrative data synthesis.…”

Insights Into Conducting Audiological Research With Clinical Databases

“…In order for an event to occur, the patient must first seek medical care. The extent to which care is sought for symptoms varies not only by symptom knowledge, interpretation, and beliefs (Petrova et al, 2019), but also by ethnicity (Williams et al, 2019), socioeconomic status (McCutchan et al, 2015, and gender (Magaard et al, 2017). Second, the presence or absence of an event is subject to the clinical judgment of a provider.…”