Marlow Laura A V, McGregor Lesley M, Nazroo James Y, Wardle Jane
Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, Gower Street, London, UK.
Psychooncology. 2014 Jul;23(7):749-57. doi: 10.1002/pon.3464. Epub 2013 Dec 19.
Earlier diagnosis of cancer has become a policy priority. There is evidence that minority ethnic groups are more likely to delay help-seeking for cancer symptoms, but few studies have explored reasons for delay in these groups. The present study explored facilitators and barriers to help-seeking for breast and cervical cancer in an ethnically diverse sample of women.
Semi-structured interviews were carried out with 54 healthy women from a range of ethnic backgrounds; Indian, Pakistani, Bangladeshi, Caribbean, African, Black British, Black other, White British and White other. Framework analysis was used to identify themes.
Appraising a symptom as possibly due to cancer was an important facilitator of help-seeking, although for some the prospect of a cancer diagnosis was a deterrent. Women believed that earlier diagnosis improved the chance of survival, and this facilitated prompt help-seeking. A sympathetic GP facilitated help-seeking, and an unsympathetic GP was a deterrent. Some ethnic minority women described the use of alternative medicine and prayer as a first-line strategy that might delay help-seeking. Language barriers, racism and a tendency to 'soldier on' were also mentioned by these women.
Models of delay in presentation for early cancer symptoms are likely to transfer across different ethnic groups. Encouraging open discussion about cancer among minority communities could help raise awareness about the importance of early detection and promote help-seeking as a priority response to a possible cancer symptom.
癌症的早期诊断已成为政策重点。有证据表明,少数族裔群体更有可能延迟寻求针对癌症症状的帮助,但很少有研究探讨这些群体延迟的原因。本研究探讨了不同种族女性样本中寻求乳腺癌和宫颈癌帮助的促进因素和障碍。
对54名来自不同种族背景的健康女性进行了半结构化访谈;这些种族包括印度裔、巴基斯坦裔、孟加拉裔、加勒比裔、非洲裔、英国黑人、其他黑人、英国白人及其他白人。采用框架分析法确定主题。
将症状评估为可能由癌症引起是寻求帮助的一个重要促进因素,尽管对一些人来说,癌症诊断的可能性是一种阻碍。女性认为早期诊断能提高生存几率,这促使她们及时寻求帮助。富有同情心的全科医生促进了寻求帮助的行为,而缺乏同情心的全科医生则是一种阻碍。一些少数族裔女性将使用替代医学和祈祷描述为可能延迟寻求帮助的一线策略。这些女性还提到了语言障碍、种族主义以及“坚持下去”的倾向。
早期癌症症状就诊延迟的模式可能在不同种族群体中具有共性。鼓励少数族裔社区公开讨论癌症,有助于提高对早期检测重要性的认识,并促进将寻求帮助作为对可能的癌症症状的优先应对措施。