Understanding GP-help seeking with potential cancer symptoms – the Understanding Symptom Experiences Fully (USEFUL) study

Problem

There is good evidence that many people delay seeking help from GPs when the develop symptoms subsequently proving to result from cancer. Understanding how and when different demographic groups currently seek help for potential cancer symptoms could highlight where interventions are needed to prompt earlier help seeking for some. This presentation reports data from the USEFUL study, a questionnaire study from nearly 15,000 UK adults aged ≥50. Of patients experiencing 25 potential cancer symptoms we wished to determine those patients that had, or had not, consulted a General Practitioner (GP) about them and how this decision was influenced by previous experience of symptoms, current health status and socio-demographic factors.

Approach

A postal survey sent to 50,000 adults aged ≥50 years around the UK. Questions asked about respondents’ experiences of, and responses to, 21 symptoms of possible cancer in the previous year. Descriptive statistics were used to summarise overall and relevant subgroup information regarding each symptom, previous experience of the symptoms, GP help-seeking behaviour, as well as demographics. Cluster analysis was used to identify distinct patterns of reported symptoms.

Findings

Poorer current health status, being unable to work and co-morbidities strongly predicted GP help-seeking with potential cancer symptoms. Lower income also appeared to increase the likelihood of GP help-seeking for symptoms of potential cancer. Previous experience of several symptoms (headache, chest pain, persistent diarrhoea, blood in stool or rectal bleeding) made it less likely that an individual will seek GP help for them, but those with bladder symptoms or weight loss were more likely to seek help. Current smokers were less likely to seek help for important potential symptoms of lung cancer. Alarm symptoms are relatively rare so targeting these symptoms to raise their salience could be beneficial and is unlikely to overwhelm health services.

Consequences

Unexpectedly those who appear to be most at risk of a protracted or non-linear route to diagnosis of cancer appear the most likely to seek help from their GP when they experience symptoms. The existing data, when interpreted along with the work of others, has considerable potential to inform the details of future campaigns aimed at particular symptoms and targeted to specific population groups. For example, smokers may need tailored information about coughing and hoarseness, and busy working professionals may need to have the value of having GI symptoms check-out emphasised to them.