Awareness and attitudes towards Cancer: Qualitative research
Summary of findings
Conclusions This audience is down to earth, blunt and does not like to make a fuss. They worry about “cancer” rather than specific types of cancer. They are very frightened of “getting cancer” and associated it with being given a death sentence. They do not know the key symptoms associated with different types of cancer, and do not fully realise the concrete benefits of early diagnosis The key symptoms are seen as vague and, with the exception of a lump in the breast, more likely to indicate a different, less serious illness. Although on reflection they can guess the symptoms associated with different types of cancer, they do not reverse-associate these, so if they had the symptom, they would not immediately link it with cancer Typical barriers in going to the GP therefore centre on fear of cancer (but without really understanding whether or not they should be worried about their symptom) and not making a fuss (because they do not know that their symptom might be cancer). Because they do not understand the symptoms, messages that focus on education are seen as key Mentioning cancer up-front can be seen as a positive – some people need to understand that a symptom could mean cancer, in order to take warnings seriously Rational appeals are interesting but do not feel personal so could be kept as supplemental information. In contrast, emotional appeals can have a strong push to the GP via their power of reframing barriers as being selfish to loved ones, and emphasising self-worth Barrier-busting statements that reiterate barriers can be seen as patronising. A more positive way of barrier-busting is to provide information about symptoms, or to present the barrier in a tonally appropriate manner, e.g. two friends chatting, as per “Cancer Chancer” This audience has a strong focus on local community, and would prefer to see messages placed in the heart of the community, particularly around public transport. Messages in a GP surgery would be expected but are seen as supplemental, as they would not be seen by GP-avoiders Of the two campaigns, “Don’t be a Cancer Chancer” was strongly preferred, and provided the strongest push to the GP. It describes symptoms in a succinct, light-hearted manner, links them to cancer with the (well-placed) tag-line, and pushes to the GP with the central message. “We’re waiting, you shouldn’t” was liked but seen as less engaging, with a central message that required thought to understand, and with no link to cancer, so could be dismissed by those with strong barriers. Any campaign should therefore include the following: - Education about key symptoms up-front and leading the campaign - The word “cancer” included – too easy for GP-avoiders to dismiss softer language, and a scary, serious wake-up call is appropriate - With a positive, hopeful, motivating focus alongside the word “cancer - Concrete benefits of early diagnosis should be stressed (not vague facts such as “it saves lives”, but hard facts such as “10000 lives”). - An emotional appeal is likely to work – “do it for them”, but not OTT emotional blackmail.
The Specific objectives of the research were to give insight into a range of specific issues: • Awareness of cancer & risks • Knowledge about symptoms • Confirm barriers to seeing a GP • Most effective language to push to seeing a GP – cancer-led v symptoms-led • Most effective type of appeal to push to see a GP – emotional v rational • Examples of existing campaigns – cancer-led (Cancer Chancer) and symptoms-led (Cough Cough):
Late diagnosis is a major contributor to poor survival rates of cancer in England. Cancer is one of the commonest causes of death and disability in Doncaster, despite good quality health services. It is also a key driver of health inequalities. Following the Department of Health’s 2007 Cancer Reform Campaign, Doncaster used social marketing techniques to improve the early diagnosis of lung cancer in the PCT. The intervention that was developed used the ‘Cough, Cough,’ creative campaign (tag line: “We’re waiting; you shouldn’t”) and was highly successful. Doncaster PCT now wished to develop a social marketing campaign to reduce cancer mortality rates by improving awareness, diagnosis and treatment of lung, bowel and breast cancer.
Research was required to inform a social marketing campaign to reduce cancer mortality rates by improving awareness, diagnosis and treatment of lung, bowel and breast cancer. As most people had little detailed knowledge of cancers other than breast cancer, education about symptoms was considered the key message area for the campaign.
• 20 men – 12 depths and 4 friendship pairs with a close male friend – C2DE audience aged 50-70 • 24 interviews with core women – 6 depths and 5 friendship pairs with a close female friend – 4 mother-daughter paired depths where mother is in core sample and adult daughter is likely to be involved in future parental healthcare – C1C2DE audience biased to C2DE. Age 45-70, biased to 50-70. • Respondents were matched to cancer profile groups • Risk factors among core sample – Approx equal numbers of smokers, non-smokers and ex smokers – Approx 1/3 of the sample were overweight / obese
Data collection methodology