International differences in cancer awareness and beliefs: The International Cancer Benchmarking Partnership


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Lindsay Forbes1
1King's College London, London, UK

Abstract

The International Cancer Benchmarking Partnership (ICBP) identified major international differences in cancer survival. For cancers of the breast, lung, bowel and ovary, one-year survival (an indicator of delayed diagnosis) in the UK and Denmark is lower than in Sweden, Norway, Australia or Canada. The ICBP is now exploring causes of these differences to inform policy and improve cancer survival. One possible explanation is that people in the UK and Denmark have lower cancer awareness and more negative beliefs about cancer, leading to delayed presentation and worse survival.

We developed and validated the Awareness and Beliefs about Cancer measure (ABC) in English, drawing on the Cancer Research UK Cancer Awareness Measure used in the UK and other survey instruments. We then developed different versions for each country, aiming to achieve local relevance and equivalence of meaning with UK English using a rigorous harmonisation process.

The ABC includes 33 questions on knowledge of cancer symptoms and age-related risk, barriers to presentation, beliefs about prognosis and the benefits of early symptomatic presentation, and fear of cancer and its treatment. Test-retest reliability and content validity index were high. Cognitive testing found that the measure was relevant, acceptable and understandable in participating countries.

We are conducting a population-based telephone survey of ~20,000 people aged 50+ living in the UK, Denmark, Sweden, Norway, Australia and Canada. We will report the levels of cancer awareness and beliefs for the UK and other countries.

The results will provide unique evidence of differences in cancer awareness and beliefs across the participating countries. Later phases of the ICBP programme will explore the effect of differences in cancer awareness and beliefs, duration of symptoms, diagnosis in primary and secondary care, comorbidity, and access to treatment on international survival differences.