How does social context influence appraisal and help-seeking for potential cancer symptoms in adults aged 50 and over? A qualitative interview study

Rosalind Adam* (Corresponding Author), Alison Jane Thornton, Katriina L. Whitaker, Peter Murchie, Philip Hannaford, Susan Hall, Sarah Smith, Alison Margaret Elliott

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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To investigate how social context and social network activation influence appraisal and help-seeking for symptoms potentially indicative of cancer.


Semi-structured telephone interview study. Community dwelling adults who had experienced at least one symptom potentially indicative of cancer within the last month were sampled from a national symptom survey.


Thirty-four interviews were conducted. Participants looked to peers and wider society to judge whether symptoms might be normal for their age. Involvement of others in symptom appraisal promoted an active management strategy, such as contacting a healthcare professional or trying a medication. There were practical, emotional, attitudinal, normative and moral barriers to involving others. Cancer narratives from significant others, public health campaigns and the media influenced symptom appraisal. Participants held mental representations of types of people who get cancer, for example, smokers and unfit people. This had two consequences. First, participants did not identify themselves as a candidate for cancer; impeding help-seeking. Second, social judgements about lifestyle introduced stigma.


Involving friends/family in symptom appraisal facilitates help-seeking but barriers exist to involving others. Campaigns to promote earlier cancer diagnosis should incorporate age-appropriate narratives, address misconceptions about ‘types’ of people who get cancer and tackle stigma about lifestyle factors.
Original languageEnglish
Article numbere13640
JournalEuropean Journal of Cancer Care
Issue number6
Early online date21 Jun 2022
Publication statusPublished - Nov 2022

Bibliographical note

Cancer Research UK (GrantNumber(s): C45810/A17927)
We thank the primary care research networks, practices and members of the public who enabled the study to happen. We are grateful to Professor Sally Wyke, University of Glasgow, for advice relating to the use of the integrated theoretical model.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.


  • cancer
  • decision making
  • early detection of cancer
  • health-seeking behaviour
  • qualitative research
  • social networking


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