Marcu, A;
Lyratzopoulos, G;
Black, G;
Vedsted, P;
Whitaker, KL;
(2016)
Educational differences in likelihood of attributing breast symptoms to cancer: A vignette-based study.
Psycho-Oncology
, 25
(10)
pp. 1191-1197.
10.1002/pon.4177.
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Abstract
BACKGROUND: Stage at diagnosis of breast cancer varies by socio-economic status (SES), with lower SES associated with poorer survival. We investigated associations between SES (indexed by education), and the likelihood of attributing breast symptoms to breast cancer. METHOD: We conducted an online survey with 961 women (47-92 years) with variable educational levels. Two vignettes depicted familiar and unfamiliar breast changes (axillary lump and nipple rash). Without making breast cancer explicit, women were asked 'What do you think this […..] could be?' After the attribution question, women were asked to indicate their level of agreement with a cancer avoidance statement ('I would not want to know if I have breast cancer'). RESULTS: Women were more likely to mention cancer as a possible cause of an axillary lump (64%) compared with nipple rash (30%). In multivariable analysis, low and mid education were independently associated with being less likely to attribute a nipple rash to cancer (OR 0.51, 0.36-0.73 and OR 0.55, 0.40-0.77, respectively). For axillary lump, low education was associated with lower likelihood of mentioning cancer as a possible cause (OR 0.58, 0.41-0.83). Although cancer avoidance was also associated with lower education, the association between education and lower likelihood of making a cancer attribution was independent. CONCLUSION: Lower education was associated with lower likelihood of making cancer attributions for both symptoms, also after adjustment for cancer avoidance. Lower likelihood of considering cancer may delay symptomatic presentation and contribute to educational differences in stage at diagnosis.
| Type: | Article |
|---|---|
| Title: | Educational differences in likelihood of attributing breast symptoms to cancer: A vignette-based study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/pon.4177 |
| Publisher version: | http://dx.doi.org/10.1002/pon.4177 |
| Language: | English |
| Additional information: | Copyright © 2016 John Wiley & Sons, Ltd. All rights reserved. This is the peer reviewed version of the following Marcu, A; Lyratzopoulos, G; Black, G; Vedsted, P; Whitaker, KL; (2016) Educational differences in likelihood of attributing breast symptoms to cancer: A vignette-based study. Psycho-Oncologywhich has been published in final form at 10.1002/pon.4177. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving, http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms |
| Keywords: | Cancer, Early diagnosis, Education, Inequalities, Oncology, Symptom attribution |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1496046 |
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