Attitudes to Cancer

  • Committee on Public Education of the Commission on Cancer Control
Conference paper
Part of the UICC Monograph Series book series (UICC, volume 5)


This chapter will deal with topics related directly to attitudes to cancer and other diseases; the nature, sources, and extent of these attitudes both in the medical profession and in the general population.


Cerebral Palsy Public Opinion American Cancer Society Psychological Impact Cancer Education 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Attitudes to Cancer

  1. Dargent, M., (1962). La cancérophobie. Acta Un. int. Cancr. 18, 709. 476 cases of cancerophobia, one third of which were neurotic, two-thirds had a normal fear. Only 3.5% of the 476 in fact had a neoplasm.Google Scholar
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  3. Donaldson, M. (1955). Cancer: The psychological disease. Lancet i, 959 and later correspondence.Google Scholar
  4. Donaldson, M. (1958). Early diagnosis of cancer. A psychological problem. Lancet ii, 790. “Although true cancerophobia is rare, both personal apprehension (which can be prevented by education) and impersonal cancer apprehension (‘f ear of creating fear’) are almost universal.”Google Scholar
  5. Levine, G. N. (1962). Anxiety about illness: Psychological and social bases. J. Hlth hum. Behav. 3, 30. National sample of 2970. Cancer more feared than polio, cerebral palsy, arthritis, birth defects and T. B. Positively correlated with fear of cancer were the factors: knowing a victim, knowledge about the disease, perceived prevalence, perceived expensiveness of treatment. Negatively correlated with fear of cancer are education and possession of adequate community medical resources.Google Scholar
  6. Nunnally jr. J. C. (1961). Popular conceptions of mental health: Their development and change, New York: Holt, Rinehart & Winston, Inc., p. 62. Incidental to the author’s examination of attitudes to mental health, he found that methods for treating cancer aroused the most anxiety when compared with methods for treating broken bones and mental illness.Google Scholar
  7. Samp, R. J. (1962). Physician poll on cancer preventon. Opinions and reactions of over 1,400 Doctors. J. Amer. med. Ass. 179, 1001. Evidence that “generally the ideas of preventing cancer seem novel, ineffective, and speculative” to doctors.Google Scholar
  8. Thomas, A. (1952). Typical patient and family attitudes. Publ. Hlth. Rep. Wash.) 67, 960. The author highlights the psychosocial, informational and experiential factors in a person’s reaction to terminal cancer. A person’s attitude to cancer will, in turn, affect that of other patients and families.Google Scholar
  9. Wakefield, J., and Davison, R. L. (1958). An answer to some criticisms of cancer education: A survey among general practitioners. Brit. med. J. i, 96. The Authors found no cancerophobia resulting from an intensive cancer education programme.Google Scholar
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Major public oplaion surveys on cancer

  1. (N.B. The dates refer to publication: in each instance the survey was carried out earlier.)Google Scholar


  1. 1964.
    Seeber, A. B. de S., Public opinion on cancer in Argentina. U.I.C.C. Bull. 2, No. 4, 3, (1964).Google Scholar

Australia, Perth

  1. 1965.
    A social survey of community attitudes to cancer. Cancer Council of Western Australia 1966.Google Scholar


  1. 1955.
    Phillips, A. J. Public opinion on cancer in Canada. Canad. med. Ass. J. 73, 639, (1955).PubMedGoogle Scholar
  2. 1961.
    Phillips, A. J., and Taylor, R. M. Public opinion on cancer in Canada: A second survey. Canad. med. Ass. J. 84, 142 (1961).PubMedGoogle Scholar

England, Manchester

  1. 1954.
    Paterson, R., and Aitken-Swan, J. Public opinion on cancer: A survey among women in The Manchester Area. Lancet ii, 857, (1954).Google Scholar
  2. 1958.
    Paterson, R., and Aitken-Swan, J. Public opinion on cancer: Changes following five years of cancer education. Lancet ii, 791, (1958).Google Scholar
  3. 1964.
    Women’s knowledge of and opinions on cancer. An Interim Pilot Survey for the Manchester Comittee on Cancer (Manchester: Derek Roe Associates Ltd.)Google Scholar


  1. 1963.
    Morandi, G., Vivori, C. e Mengon, M., Le conoscenze e gli orientamenti del pubblico in tema di tumori maligni [Public opinion and knowledge about cancer]. Riv. med. Trentina 1, 69, (1963). (Italian text.)Google Scholar


  1. 1963.
    Sawicki, F. Opinia publiczna o nowotworach [Public opinion about neoplastic diseases]. Zdrow. publ. 12, 599, (1963). (Russian and English Summaries.)Google Scholar

United States of America

  1. 1948.
    Summarized in 1956 and 1964 (below).Google Scholar
  2. 1956.
    Horn, D. et al. Public opinion on cancer and the American Cancer Society: A report of a national Sample Survey. New York: American Cancer Society Inc. 1956.Google Scholar
  3. 1964.
    Horn, D., and Waingrow, S. What changes are occuring in public opinion toward cancer: National public opinion survey. Amer. J. publ. Hlth. 54, 431, (1964).Google Scholar

Other references

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Delay studies

  1. [For studies included in the extensive reviews by Kutner et. al. (1958) and Blackwell (1963) a reference only is quoted. Other studies are briefly annotated.]Google Scholar
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  6. (Hebrew Text). 201 consecutive cases from The Rothschild Hadassah — University Hospital 1955 — 1958. Analysed according to site and responsibility for delay. 17% of the Patients delayed less than two months, 23 % more than a year. The percentages for doctor — delay were 50 % and 13 % respectively.Google Scholar
  7. Blackwell, B. L. (1963). The literature of delay in seeking medical care for chronic illnesses. Health Education Monographs. No 16. Most of this review is taken up with a consideration of cancer delay, since little has been done in other fields. It is divided into sections dealing with separate aspects of delay: existence and length of delay; site of the cancer; delay as related to personal, physical and social attributes; psychological factors associated with delay; personality of the delayer; and factors which lead to seeking care. The remainder of the work is devoted to what little has been done with respect to other chronic illnesses and psychoneuroses.Google Scholar
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  13. Cobb, B., Clark, R. L. jr., Mcguire, C., and Howe, C. D. (1954). Patient — responsible delay of treatment in cancer: A social psychological study. Cancer, (Philad.) 7, 920.Google Scholar
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  21. Flowers jr. C. E., Ross, R. A., and Pritchett, N. L. (1958). Delay by physician and patient in the diagnosis and treatment of pelvic cancer. Sth. medical J. (Bgham, Ala.) 51, 1497. 191 cases were studied: of 131 cases of carcinoma of the cervix 70 (54 %) showed no symptoms, but of the remainder 16 % (21 cases) of the patients delayed, 30% (37 cases) of the physicians delayed. For carcinoma of the endometrium the figures were 16 % and 20 % for patient and physician delay respectively. 75 % of the cases of carcinoma of the vulva and vagina delayed. Delay in diagnosis could have been reduced in 64 % of the cases by annual examination.Google Scholar
  22. Goldsen, R. K. (1963). Patient delay in seeking cancer diagnosis: Behavioral aspects. J. chron. Dis. 16, 427.PubMedGoogle Scholar
  23. Goldsen, R. K., Gerhardt, P. R., and Handy, V. H. (1957). Some factors related to patient delay in seeking diagnosis for cancer symptoms. Cancer (Philad) 10, 1.PubMedGoogle Scholar
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  25. Graziani, E. C. (1955). Quoted lrn: Causes of delay in diagnosis of cancer. J. Amer. med. Ass. 158, 968. A study of one thousand patients in Peru. The figures for delay were fairly close to those in other countries. The main difference was that more responsibility for delay lay with the patient and less with the doctor. Ignorance was the most important cause of patient delay.Google Scholar
  26. Hammerschlag, C. A., Fisher, S., De Cosse, J., and Kaplan, E. (1964). Breast symptoms and patient delay: Psychological variables involved. Cancer (Philad.) 17, 1480. Sample of forty-one patients. Tested two hypotheses: (1) that people with more sharply (subjectively) defined body boundaries would delay more, and (2) that a person who habitually employs the defence-mechanisms of denial or repression would delay more. The first hypothesis was supported, the second was not. The authors suggest that those who have a well-defined body boundary “feel more secure about their bodies, less threatened by its symptomatic alteration, and, therefore, had less need to seek immediate assistance”. Furthermore, it was suggested, they delayed even more because they were less willing to enter into a submissive, dependent relationship such as exists between patient and doctor, or in a hospital. The authors suggested that one implication of their findings is that emphasis on the personal responsibility of the individual will be most effective (if not essential) in educating such people (delayers) to seek treatment early.PubMedGoogle Scholar
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  38. The authors distinguish between delay and procrastination. Delay can be unavoidable or avoidable. Only avoidable delay can be truly called procrastination; it is a failure to seek medical attention once the symptoms appear and are recognized as significant. The distinction made here is (a) between biological onset and first appearance of symptoms, and (b) between this appearance and the patient’s recognition of a legitimate medical complaint. To distinguish thus between causes of delay (insidious nature of the disease, failure to appreciate the significance of the early symptoms of cancer, and the true procrastination) is important in constructing hypotheses regarding delay and in understanding variations in behaviour within and between populations.Google Scholar
  39. The authors make a very extensive review of earlier studies dealing with:(1) The prevalence of delay on the part of both patients and doctors. (2) Duration of patient-delay and doctor-delay. (3) Reasons for delay considered under several headings: patient-delay (knowledge of symptoms etc., psychological factors); physician-delay (failure to examine, diagnostic failure, wrong treatment or advice, medical attitudes and beliefs, insensitivity to the medical problem and to the patient, pessimism etc.).Google Scholar
  40. The discussion points out some of the major inadequacies of the studies reviewed, and calls into question the vast majority, since they “neither provide for individual differences in the basic reasons for promptness and delay, nor for individual differences regarding the site, symptomatology, and severity of the disease and the symptomatic onset”. Finally, the authors consider some of the problems which their review of the literature on delay has shown to be in need of further research.Google Scholar
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  60. Sugar, M., and Watkins, C. (1961). Some observations about patients with a breast mass. Cancer (Philad.) 14, 979. A study of 50 patients prior to final diagnosis in order to discover why they delayed. Briefly stated, the conclusions were that cancer patients delayed and were depressed. Delay was not associated with knowledge of cancer symptoms nor was it caused by fear of what would be found. The non-delayer tended to show anxiety, while the delayer exhibited depression and little fear. By comparison, the patients who in fact had benign lesions were anxious and did not delay.Google Scholar
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© Springer-Verlag Berlin Heidelberg 1967

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  • Committee on Public Education of the Commission on Cancer Control

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