Fifty shades of cancer fear revisited

Do you sometimes worry about how your life would change if you were diagnosed with cancer? Most people do. And perhaps unsurprisingly so, because research shows that if you are born after 1960, there’s a 50% chance that you’ll get cancer at some point during your life.*[1]

In a previous post, we described what it is that ordinary, healthy people worry about if they worry about being diagnosed with cancer, such as cancer treatment, how a diagnosis would affect loved ones, and death. But from the way we carried out that research, we couldn’t tell how common those worries are in the general population. We also couldn’t tell how these worries might influence engagement with cancer prevention and early diagnosis efforts, such as cancer screening. So in our latest two studies, we have looked at these questions.

In our first study, we examined how common twelve worries about cancer are.[2] We found that worries about the emotional and physical effects of a cancer diagnosis were much more common than worries about the social consequences. For example, two out of three people would be ‘quite’ or ‘extremely’ worried about the threat to life and emotional upset that a diagnosis would cause. One in two people would worry about surgery, radiotherapy, chemotherapy, and loss of control over life, while just under half would worry about financial problems or the effect of a cancer diagnosis on their social roles. One in every four people would be worried about effects on their identity, important relationships, gender role, and sexuality.

We also looked at whether some groups of people in the population worry more about these things than others. We found that women and those who are younger tend to worry more about all aspects of cancer. Interestingly, those from an ethnic minority background worried just as much about the physical and emotional impact of a cancer diagnosis as their White counterparts, but were more worried about the social consequences of a cancer diagnosis than those from White backgrounds. This might be because cancer tends to be more stigmatised or taboo in some ethnic minority communities,[3] and this is something we are currently doing more research on.

In our second study, we examined the association of these worries with uptake of screening for breast, cervical, and bowel cancer.[4] We found that men and women who worried about the emotional and physical consequences of a cancer diagnosis were more likely to take part in bowel cancer screening, while women who worried about the social implications of a cancer diagnosis were less likely to go for breast or cervical screening.

What can we conclude from this? First, being worried about cancer is an unpleasant emotion and may keep people from taking part in cancer screening or going to the doctor when they have a symptom that might be cancer. This could lead to delays in diagnosis and treatment, and worse outcomes. By better understanding what it is that people tend to worry about when it comes to cancer, we may be able to allay some of their worries, improve informed participation in screening, and encourage prompt help-seeking for symptoms.

* For those of you born before 1960, your chance of developing cancer during your lifetime is 1 in 3.

[1] Ahmad AS, Ormiston-Smith N, Sasieni PD. Trends in the lifetime risk of developing cancer in Great Britain: comparison of risk for those born from 1930 to 1960. British Journal of Cancer, 2015;112:943-7.
[2] Murphy PJ, Marlow LAV, Waller J, Vrinten C. What is it about a cancer diagnosis that would worry people? A population-based survey of adults in England. BMC Cancer, 2018;18:86.
[3] Marlow LA, Waller J, Wardle J. Barriers to cervical cancer screening among ethnic minority women: a qualitative study. J Fam Plan Reprod Health Care. 2015;41:248–54.
[4] Quaife SL, Waller J, von Wagner C, Vrinten C. Cancer worries and uptake of breast, cervical, and colorectal cancer screening: a population-based survey in England. Journal of Medical Screening, 2018. [Epub ahead of print]