To improve cancer survival rates British stoicism must be challenged

The British Journal of Cancer has today reported on a study of 20,000 people across six developed countries about their knowledge of cancer symptoms and motivation to seek help. The results provide cultural evidence to explain why the UK’s cancer survival rates are the lowest of Australia, Canada, Denmark, Norway and Sweden, despite similar levels of awareness about cancer symptoms and access to medical professionals and treatments. British respondents are more reluctant to seek help, and by failing to seek help early, if at all, their cancer is detected at a later stage where treatment and survival can be comprised. This comes as no surprise to us, as our work talking to people with lung cancer and bowel cancer echoes these findings. So many people have said to us that they would feel embarrassed to share their symptoms, they are fearful of wasting doctors’  time, and worried about not been a serious enough case when compared with others. Public health and other health promotion initiatives have tried to tackle these barriers and reinforce the importance of seeking help with recognised symptoms.  And yet, as this report shows, the public aren’t convinced and they stay away, with the result that over 5000 people are losing their lives unnecessarily (if we were to match the survival rates of other countries). It seems to us that whilst the public feel that our GPs are over-worked and appointment times restricted, that they will be reluctant to be seen to contribute to this problem. And so we must convey that health professionals are both approachable and accessible. Older people in particular want to be granted ‘permission’ to visit. Realistically, this can’t come from GPs. We all know the pressures they face, and even more so with their commissioning responsibilities. Isn’t it time then for practice nurses and health care assistants to be given greater opportunities to provide a frontline service, that is steeped in being personal, caring and welcoming. And for this to become an expected norm amongst patients to see nurses rather than doctors in the first instance? Without a fundamental rethink, it doesn’t seem otherwise very realistic to expect the public to swallow their somewhat misplaced sense of concern for GPs.