Quaife S L, McEwen A, Janes S M, Wardle J
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK.
Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, Rayne Building, University College London, 5 University Street, London WC1E 6JF, UK.
Br J Cancer. 2015 May 26;112(11):1799-804. doi: 10.1038/bjc.2015.148. Epub 2015 May 7.
Smoking cessation is the key cancer prevention behaviour for smokers; nonetheless, smokers can still benefit from earlier diagnosis of cancer. However, fewer smokers participate in screening despite their increased risk, which may reflect different beliefs about cancer.
A UK population-representative sample of ⩾50 year-olds (n=6965) was surveyed using the Awareness and Beliefs about Cancer measure. These analyses examine six items on cancer beliefs (e.g., 'cancer can often be cured'), and four on help-seeking barriers (e.g., 'I would be too embarrassed').
Smokers were more likely to hold pessimistic cancer beliefs than never-smokers or former-smokers on four of six items. For example, 34% agreed 'a cancer diagnosis is a death sentence', compared with 24% of non/former-smokers (P<0.001). More smokers (18%) than non/former-smokers (11%) would not want to know if they had cancer (P<0.01). The only barrier to symptomatic help-seeking differing by smoking status was 'worry about what the doctor might find' (36% vs 28%, P<0.01). Associations were independent of demographics, self-rated health and cancer experience.
Smokers held more pessimistic and avoidant beliefs about cancer, which could deter early-detection behaviour. A better understanding of these beliefs is needed to increase engagement in early diagnosis by this high-risk group.
戒烟是吸烟者预防癌症的关键行为；尽管如此，吸烟者仍能从癌症的早期诊断中获益。然而，尽管吸烟者患癌风险增加，但参与筛查的人数较少，这可能反映了他们对癌症的不同看法。
使用癌症认知与信念量表对英国⩾50岁的具有代表性的样本（n = 6965）进行了调查。这些分析考察了关于癌症信念的六个项目（例如，“癌症通常可以治愈”），以及关于寻求帮助障碍的四个项目（例如，“我会太尴尬”）。
在六个项目中的四个项目上，吸烟者比从不吸烟者或曾经吸烟者更倾向于持有悲观的癌症信念。例如，34%的人同意“癌症诊断等同于死刑判决”，而非吸烟者/曾经吸烟者中这一比例为24%（P < 0.001）。与非吸烟者/曾经吸烟者（11%）相比，更多吸烟者（18%）不想知道自己是否患有癌症（P < 0.01）。因吸烟状况不同而存在差异的寻求症状性帮助的唯一障碍是“担心医生可能发现的情况”（36%对28%，P < 0.01）。这些关联独立于人口统计学特征、自我评估的健康状况和癌症经历。
吸烟者对癌症持有更悲观和回避的信念，这可能会阻碍早期检测行为。需要更好地理解这些信念，以提高这一高危群体对早期诊断的参与度。
