Investigating a community intervention to promote quality of life and help-seeking for potential cancer symptoms

Abstract

Background: Detecting bodily change is an important step towards diagnosing cancer and the Pathways to Treatment Model acknowledges this. Delays in help-seeking can affect survival. As quality of life (QoL) is affected by the presence of cancer, we investigated whether feeding-back personal QoL results at this early stage benefits wellbeing in those with suspected cancer, and enhances help-seeking. Methods: Adults were recruited at a CRUK roadshow during its visits to socio-economically deprived communities. Specialist nurses sign-posted visitors to primary care. A 2x2 design was used in this pilot study. Participants were randomly allocated to an Intervention group (QoL feedback, self-management and resources), or a Control group (QoL assessment or none). They were naturalistically assigned to a Symptoms group, if cancer was suspected, or a Lifestyle group, if seeking cancer risk reduction advice. Participants completed the WHOQOL-BREF; WHOQOL Importance measure; Changes to QoL; Depressive symptoms (PHQ-2), and help-seeking questionnaires. Results: From a total of 107 (50% male), 57% had not received higher education; 66% did not work, and 45% were ill. Follow-up 1 (FU1) was conducted 2 (n=68), and 10 weeks (FU2) (n=54) after baseline; 54% of the Symptoms group sought help at FU1, and a further 55% at FU2. No QoL improvements were recorded for the Symptoms group after the Intervention, but the Lifestyle group reported improved psychological QoL; depression was a covariate (MANCOVA). Conclusion: In deprived communities the Intervention is not suited to those with suspected cancer symptom, but those seeking lifestyle advice confirm substantial benefits to wellbeing.