Revisiting Candidacy: What Might It Offer Cancer Prevention?

Abstract

The notion of candidacy emerged three decades ago through Davison and colleagues’ exploration of people’s understanding of the causes of coronary heart disease. Candidacy was a mechanism to estimate one’s own or others risk of disease informed by their lay epidemiology. It could predict who would develop illness or explain why someone succumbed to it. Candidacy’s predictive ability, however, was fallible, and it was from this perspective that the public’s reticence to adhere to prevention messages could be explained, as ultimately anybody could be ‘at-risk’. This work continues to resonate in health research, with over 700 citations of Davison’s Candidacy paper. Less explored however, is the candidacy framework in its entirety in other illness spheres, where prevention efforts could potentially impact health outcomes. This paper revisits the candidacy framework to reconsider it use within prevention. In doing so, candidacy within coronary heart disease, suicide prevention, diabetes, and cancer will be examined, and key components of candidacy and how people negotiate their candidacy within differing disease contexts will be uncovered. The applicability of candidacy to address modifiable breast cancer risk factors or cancer prevention more broadly will be considered, as will the implications for public health policy.

How does social context influence appraisal and help‐seeking for potential cancer symptoms in adults aged 50 and over? A qualitative interview study

“…Candidacy has been identified as a promising framework on which to base cancer prevention campaigns (Batchelor et al, 2021 ). Our study suggests that cancer candidacy may also be a useful framework on which to modify individual responses to symptoms .…”

“…Candidacy has been identified as a promising framework on which to base cancer prevention campaigns (Batchelor et al, 2021).…”

Extending the sociology of candidacy: Bourdieu’s relational social class and mid‐life women’s perceptions of alcohol‐related breast cancer risk

“…As described by Davison et al (1991), people use 'lay epidemiology' their knowledge and observations of disease gathered through personal and public domains-to shape their sense of T A B L E 1 Enactments of candidacy (Batchelor et al, 2021).…”

“…While Davison’s study is highly regarded (Armstrong, 2003), candidacy has since received little empirical testing or theoretical extension, but its genealogy is traced by papers in this journal—from lay understandings of coronary heart disease (CHD) (Davison et al., 1991), to the gendered aspects of coronary candidacy (Emslie et al., 2001b) and later cancer candidacy (Macdonald et al., 2013). Our recent conceptual paper (Batchelor et al., 2021) examined the application and applicability of ‘candidacy’ in varying disease contexts. This illuminated the different social constructs that comprise candidacy and shape enactments, including changes or persistence in health ‘risk’ behaviours such as resisting or competing candidacy.…”

“…Literature on lay understandings of health/health risks informs our work, but an explication of ideas and literature on lay ideas of health risk is not within the scope of the article. We revisited Davison et al.’s (1991) candidacy framework and its use‐value for understanding participation in breast cancer prevention activities elsewhere, in a conceptual paper we recently published (Batchelor et al., 2021).…”