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People don't know signs of cancer

Monday 17 August 2009

Today, several papers and news sources have reported on the widespread lack of cancer knowledge in the UK. The Daily Telegraph says that one in seven of us cannot identify a single cancer symptom, and that as many as 5,000 people a year may be dying unnecessarily due to a lack of awareness about their symptoms.

Cancer Research UK, the organisation that conducted the survey, is quoted in the Metro as saying that being aware of changes that may signify cancer “could make a crucial difference for people who develop the disease”.

What is the basis for these current reports?

Cancer Research UK (CRUK) is an independent charitable organisation dedicated to researching cancer. CRUK has several goals in the fight against cancer, including educating the public about how to reduce their risk of cancer, reducing the prevalence of smoking, working towards earlier diagnosis, and improving treatments.

In October 2008, CRUK commissioned the British Market Research Bureau to carry out a survey that asked nearly 4,000 people whether or not they could “name any sign or symptoms that could be an indication of cancer”. People were not offered a list of options to choose from. The news sources are responding to the results of this survey, which were published today by Cancer Research UK.

The methods of the survey are not quite clear. We are not certain how people were asked this question, whether it was translated appropriately, and whether respondents were in a situation where they felt comfortable answering.

What were the results of the survey?

Cancer Research UK gives the results of the survey on its website. Overall, of the nearly 4,000 people questioned, 19% of men and 10% of women could not name a single symptom that might be a sign of cancer.

Specific findings included:

  • 54% of respondents volunteered a ‘lump’ as being a sign of cancer
  • 25% said skin problems
  • 16% said moles
  • 19% mentioned bowel, urinary or toilet problems
  • 16% of males reported weight loss
  • 22% of females reported weight loss
  • 13% of white respondents could not name a sign or symptom of cancer
  • 28% of ethnic minority respondents could not name a sign or symptom of cancer

What are the common signs and symptoms of cancer?

NHS Choices and Cancer Research UK both aim to provide simple, reliable information on the possible signs and symptoms of cancer.

Developing any of these symptoms does not definitely mean that a person has cancer, but it is important to speak to a doctor if they appear. These potential warning signs include:

  • unexplained weight loss (see information box),
  • unusual swellings or lumps anywhere on the body,
  • changes in the size, shape or colour of a mole,
  • ulcers or sores that won’t heal,
  • blood in urine or faeces,
  • changes in bowel habits that last longer than six weeks,
  • problems passing urine,
  • a cough or hoarse voice persisting for longer than three weeks,
  • difficulties swallowing,
  • heavy night sweats,
  • unexplained persistent pain lasting longer than four weeks, and
  • for women, unusual change to the breast, or vaginal bleeding after menopause or between periods.

What are the benefits knowing the signs of cancer?

It is important to be aware of the signs and symptoms of cancer because early diagnosis of the disease greatly improves the chances of treating it successfully. When cancer is left untreated it is more likely to spread to other organs or sites of the body, making it more difficult to treat successfully. The survival of people with most cancers is much better in cases where the cancer is identified before it has spread.

Cancer Research UK give several examples of just how important an early diagnosis can be:

  • The survival rate for lung cancer is generally quite poor because the disease is usually diagnosed when it is at an advanced stage. Only 7% of people will be alive five years after their diagnosis. However, if lung cancer is diagnosed at its earliest stage, as many as 80% of people affected will be alive five years after their diagnosis.
  • Malignant melanoma, the most serious skin cancer, provides another example. Only 47% of men and 55% of women will be alive after five years if the melanoma is more than 3.5mm thick when it is diagnosed. However, if the melanoma is diagnosed when it is less than 1.5mm thick, 93% of men and 97% of women will be alive five years after they are diagnosed.

Treatment options for cancer are improving all the time, and the number of people who die from their disease is falling overall. Improved treatments for testicular cancer, for example, mean that if diagnosed early, more than 90% of men are cured.

Sara Hiom, the director of health information at Cancer Research UK, estimates that “as many as 5,000 deaths could be avoided each year in the UK if cancers were diagnosed early”.

What impact could this survey have?

Press coverage on this survey will increase knowledge of some of the early warning signs of cancer, and the research could help cancer awareness strategies through initiatives such as The National Awareness and Early Diagnosis Initiative (NAEDI). NAEDI is a collaboration between Cancer Research UK and the NHS, and it is likely that this recent press release is connected to the National Cancer Awareness Survey, which has been developed as part of NAEDI.

The wider role of NAEDI is to “coordinate and provide support to activities that promote the earlier diagnosis of cancer” by:

  • measuring awareness of cancer,
  • encouraging earlier presentation,
  • reducing delays in primary care,
  • providing key messages,
  • looking at the evidence,
  • comparing the situation in the UK with other countries to try and understand the differences,
  • undertake new research, and
  • evaluating new diagnostic techniques.

The initiative led by Mike Richards, the National Cancer Director and Harpal Kumar, chief executive of Cancer Research UK, is an important part of the National Cancer Reform Strategy, which sets out the goals and pathways for the NHS to improve cancer treatment and patient outcomes in the UK. There is more about the NAEDI initiative on the CRUK website.

Analysis by Bazian
Edited by NHS Website

Links to the headlines

‘Deadly ignorance’ about cancer signs

Metro, 17 August 2009

One in seven cannot name cancer symptom, says Cancer Research

The Daily Telegraph, 17 August 2009

Links to the science

Cancer Research UK:

Brits risk late cancer diagnosis because of poor symptom awareness