Cancer, cancerphobia, and culture: reflections on attitudes in the United States and Great Britain

Cancer as the "perfect storm"? A qualitative study of public attitudes to health conditions

Aims

Our aim is to identify important attributes of major diseases that shape how they are perceived by the public.

Methods and Results

Four focus groups among members of the public were recruited, in March and October 2016, and used semistructured discussion to explore important attributes of cancer, heart disease, stroke, dementia, mental illness, and infectious disease. Common themes were identified by using inductive thematic analysis.Five themes were identified: fear, impact on family and friends, hope, detection, and prevention. Fear of cancer includes not only fear of death but also of aggressive treatments. Loss of dignity is feared in dementia, while infectious disease raises fear of uncontrollable "plague"; in contrast, people with mental illness may themselves be seen as a potential threat. The impact of cancer and its treatment on family and friends was described as intense and all-consuming, even for those not involved directly in caring; with dementia and stroke, the family impact is taking on care, including funding, over the long term with little expectation of improvement. Hope is a major theme in cancer and stroke recovery, linked with the need to take action, often expressed in aggressive language of "fighting," but seen as futile in dementia. Detection difficulties for "silent" cancers mean that real treatment opportunities are missed; cardiovascular and infection risk, however, are seen as easy to identify and act on, whereas mental illness and dementia are seen as poorly diagnosed and with limited treatment options. Prevention awareness is high for cardiovascular disease and infection, lower for cancer, and limited for dementia and mental health.

Conclusion

Although themes overlap across diseases, the specific concerns are different and each condition has a unique profile. Quantifying the relative importance of these themes could allow their incorporation in decision-making, not only when they occur as a named disease but also in any relevant condition.

The British Fight against Cancer: Publicity and Education, 1900–1948

This article explores the early history of cancer education in Britain, focusing on the period between 1900, when discussions about a public ‘crusade’ against cancer began in Britain, and the foundation of the National Health Service (NHS) in 1948. Arising from debates around the development of invasive operations for cervical cancer, the campaign had a cautious start because of important uncertainties about the efficacy of available therapies, worries about the undesirable effects of partial knowledge, and anxieties about creating demands that could not be fulfilled. Against this background, anti-cancer activists attempted to produce a discourse which would not undermine people's faith in medical science, and which would encourage people to consult their doctors without putting excessive pressure on health services funded by public money. A ‘regime’ of hope came to the fore that served to draw patients, philanthropists, practitioners and researchers together into a joint market agenda.