How our politeness could prove fatal

Cancer survival rates lag Europe because patients are too reticent, survey suggests

Cancer patients are dying because they are too polite, a survey has revealed.

Almost 40 per cent of people say they would put off going to their GP with symptoms because they did not want to bother the doctor. Embarrassment, anxiety and being too busy were other reasons given for delaying a visit.

The findings support what experts have long suspected – that British reticence is a factor behind the NHS's poor record in the European cancer survival league.

In cancer, reticence can be a death sentence and good manners can delay recovery. Comparisons with other countries show that up to 11,000 cancer deaths could be prevented every year if Britain improved its survival rates to match the best-performing nations in Europe.

Patients who seek early diagnosis of their symptoms, press for the best treatments and don't take "no" for an answer have the best chance of survival. Ignoring symptoms such as a lump in the breast, blood in the faeces or a persistent cough means the chances of recovery are reduced.

Professor Jane Wardle, of the health behaviour research unit at University College London, said: "If we were to carry out this survey in other countries, I suspect that the results might be different, because it's typically British to think 'I mustn't bother the doctor'. But when this etiquette stops us talking to the GP about potentially serious symptoms, it can be dangerous."

The survey, funded by Cancer Research UK and published online in the British Journal of Cancer, indicated that affluent people put off seeing the doctor because they were too busy or had too many other things to think about, while poorer people were more likely to delay because they were embarrassed or worried about what they might discover. Professor Wardle said: "A lot of work now needs to be done to help people feel like they can go to their doctor as soon as they find something that could be a symptom of cancer. Changes to public attitudes along with changes within the healthcare system will be fundamental to making a difference."

Last year, Professor Mike Richards, the Government's cancer tsar, suggested that British stoicism could lie behind the country's poor showing on cancer survival compared with other countries. "If we can tackle delays in diagnosing cancer, we will be able to save thousands more lives," he said.

The problem of excessive politeness leading to poorer survival among cancer patients was raised a decade ago by the Patients Association.

Cathy Gritzner, the association's former chief executive, said women in particular were liable to hang back in seeking treatment and worry about being too demanding. Ms Gritzner said the "yes, doctor" syndrome was one reason for this. "We have a lot to learn from the Americans. We should be more assertive," she said.

One of the most common complaints of women with breast cancer is how their fear of the disease taking over their bodies was compounded by the way the medical system took over their lives.

Sara Hiom, director of health information at Cancer Research UK, who worked on the survey, said: "We wanted to find out why we were behind the best in Europe on early diagnosis. This survey will be a baseline for understanding why people sometimes put off such a crucial appointment, and for measuring any initiatives that aim to fix this problem."

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