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‘Health Chatter’: Research Department of Behavioural Science and Health Blog



Remembering Professor Jane Wardle – Part 4 – Fear of cancer

By rmjdafo, on 17 January 2016

In the fourth post in our series on the contribution that Professor Jane Wardle made to the field of cancer behavioural science, Charlotte Vrinten and Sammy Quaife write about fear of cancer and how it affects cancer prevention.

Jane and cancer fear

As a cancer patient, Jane had first-hand experience of the emotional reactions that may follow a cancer diagnosis.  In her article in the Guardian, she described the shock of learning of her diagnosis, which was followed by ‘every variation of denial’, sadness and depression, and fear of the ‘abyss that she had seen’.  As someone who ‘had a foot in both camps’, she realised that this emotional reaction to cancer not only affects cancer patients, but also exerts its influence on the general population.  Crucial to Jane’s work as a psychological researcher into the prevention of cancer, she understood that the fear of being diagnosed with cancer keeps many from engaging with cancer screening or early detection.  Cancer is not generally a club you want to be a member of.

Her work showed that although much progress has been made in the treatment of cancer, it is still a widely feared disease.  Her studies of population-based samples showed that 50-70% of adults are scared of cancer, and about a quarter worry a lot about cancer (McCaffery, Wardle, Waller, Prev Med, 2003; Vrinten et al, BMC Cancer, 2014).  They also identified women and those who are younger, with less education, or from ethnic minority backgrounds as subgroups that are particularly afraid of cancer – a finding which may help explain differences in help-seeking for cancer symptoms or uptake of cancer screening.

As a Behavioural Scientist, Jane sought to understand how cancer fear may affect early detection behaviour, and this took centre-stage in her research on this topic.  Her findings suggest that while a little fear or worry may motivate people to attend cancer screening, high levels may deter them; both from flexible sigmoidoscopy and FOBt screening.  The addition of fatalistic beliefs to cancer fear seem to exacerbate this effect, leading to delays in seeking help for possible cancer symptoms, and avoidance of information about cancer, which may perpetuate these negative feelings and views.  More recently, Jane extended this work to lung cancer, in an ongoing programme of work exploring the psychosocial deterrents to screening among smokers from socioeconomically deprived communities, and trialling a targeted invitation strategy which aims to minimise fear, fatalism and stigma.

One of Jane’s recent qualitative studies revealed that many people seem to be ‘in two minds’ about cancer; first expressing fear and thoughts of death, but then acknowledging (often in the same sentence) improvements in cancer treatment, survival and quality of life.  Her population-based study supported this co-existence of positive and negative cancer beliefs, particularly among individuals with lower levels of education.  Messages of improved outcomes and survival seem to be sinking in, but many people’s gut feeling about cancer remains one of dread.

Public campaigns tend to focus on increasing public fear about cancer – for example by emphasising how common cancer is or how deadly some types of cancer are.  But Jane recognised that worrying about cancer can impair quality of life, and feeling afraid of cancer can cost a person their life if it puts them off going for screening or getting medical help for symptoms.  Having faced the abyss herself, Jane was committed to helping people understand that there is a lot that they can do to lower their risk of cancer, that cancer outcomes are continually improving, and that there is no need for it to be the great dread it used to be.

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