Table 1. Risk factors for patient-mediated delay.
Risk factor | Breast | Upper GIa | Colorectal | Urob | Gync | Lung |
---|---|---|---|---|---|---|
Demographic | ||||||
Age (older) | ↑ | ⊙ | = | = | ⊙ | = |
Sex (male) | N/A | = | = | ↑ | N/A | = |
Socio-economic status (lower) | ⊙ | ↑ | = | ↑ | = | = |
Education level (lower) | ↑ | ⊙ | ↑ | = | = | = |
Ethnicity (non-white origin) | ↑ | ↓ | ⊙ | ↑ | = | ○ |
Marital status (married/co-habiting) | = | = | ⊙ | = | = | = |
Clinical | ||||||
Symptom type | ↑ | ↑ | ↑ | ↑ | ↑ | ⊙ |
Symptom – pain | ◊ | ↓ | ↓ | ↑ | ↓ | ⊙ |
Symptom – bleeding | ◊ | ↓ | ⊙ | ↓ | ↓ | ○ |
Symptom impacts on daily life | ○ | ↓ | ↓ | ↓ | ↓ | ↓ |
Co-morbidity | ○ | ↓ | ↓ | ○ | ○ | = |
Infrequent care seeking | ○ | ○ | ⊙ | ↑ | ↑ | ○ |
Personal/family history of cancer | ○ | ⊙ | ⊙ | ↓ | ○ | ⊙ |
Psychosocial | ||||||
Non-recognition of symptom seriousness | ↑ | ↑ | ↑ | ↑ | ↑ | ↑ |
Fear | ○ | ↑ | ↑ | ↑ | ↑ | ↑ |
Embarrassment | ○ | ○ | ↑ | ↑ | ○ | ○ |
Social support/advice | ↓ | = | ↓ | = | ↓ | = |
Abbreviation: GI=gastrointestinal.
Key: ↑ increases delay; ↓ reduces delay; = no impact on delay; ⊙ inconclusive evidence; ○ lacking evidence; ◊ any non-lump symptom.
Risk factor included only if supported by studies providing strong or moderate levels of evidence (Sources: Ramirez et al, 1999; Macdonald et al, 2004, 2006; Mitchell et al, 2008).
Duodenum, oesophagus, pancreas, small intestine, stomach.
Bladder, kidney, prostate, testes.
Cervix, endometrium, ovary, uterus, vagina, vulva.