“Having an all-clear now doesn’t guarantee that you won’t develop cancer in the future” – Dr Cristina Renzi
More than 80 per cent of patients with potential cancer symptoms are given the all-clear after investigations. But according to research* published by BMJ Open (link is external), having a false alarm might discourage people from seeking help, even years later, if they notice possible symptoms of the disease again.
The researchers, from the Health Behaviour Research Centre at UCL (link is external)(University College London), carried out a review**, funded by Cancer Research UK, of 19 UK and international studies. It suggested that patients may delay seeking help for new or recurrent symptoms if they feel ‘over-reassured’ following a previous false alarm or felt under-supported at the time by the healthcare system.
If patients felt unsupported and believed they had been treated dismissively, some had concerns they might appear to be a hypochondriac or making a fuss if they had future symptoms checked out.
Several studies also reported that insufficient explanation or advice at the time of the false alarm, on possible causes of the symptoms or the next steps, left patients feeling that doctors could not help them, and unsure about what to do next.
Lead author Dr Cristina Renzi, a Cancer Research UK health expert at UCL, said: “Patients who go to their GP with symptoms are obviously relieved to find out that they don’t have cancer. But, as our review showed, it’s important that they don’t have a false sense of security and understand they should still seek help if they notice new or recurrent symptoms. Having an all-clear now doesn’t guarantee that you won’t develop cancer in the future.
“It also appears to be important that patients are given the right support and information during and after cancer investigations so that, following a false alarm, they will still feel encouraged to get any new symptoms checked out quickly.”
The researchers concluded that providing appropriate, balanced information to patients who have a cancer false alarm, including making sure they don’t feel foolish about having sought help, might encourage them to check out any future symptoms earlier. When cancer is diagnosed at an early stage, treatment is more likely to be successful.
The review indicated that over-reassurance could lead to patients, and sometimes clinicians, linking any future symptoms to the earlier all-clear. In the case of breast symptoms, a benign biopsy result appeared to give some women a false sense of security for many years, with some also reporting being less breast aware even though there would be no guarantee they could not develop breast cancer in the future.
Sara Hiom, Cancer Research UK’s director of early diagnosis, said: “It’s vitally important that anyone with possible cancer symptoms gets them checked out as soon as possible, and that includes people who have had a false alarm in the past. You’re not wasting your doctor’s time and may well save time in the long run – most cancers are picked up after patients seek help about symptoms and acting promptly on these can mean treatments are simpler and more effective.
“More research is needed into the best ways to ensure patients are never discouraged from talking to their GP about symptoms, even after receiving an all-clear.”
For media enquiries contact the Cancer Research UK press office on 020 3469 8300 or, out of hours, on 07050 264 059.
*Cristina Renzi, Katriina L Whitaker and Jane Wardle: Over-reassurance and under-support after a ‘false alarm’: a systematic review of the impact on subsequent cancer symptom attribution and help-seeking. http://bmjopen.bmj.com/content/5/2/e007002.full?sid=c53a2bc4-8940-4c55-9b03-714b735e4fb7 (link is external)
Notes to Editor
** The review focused on 19 research papers which reported information on false alarms and subsequent symptom attribution or help-seeking. Six of these were carried out in the UK, three in other European countries, six in the USA, three in Canada and one in Australia. The most frequently studied cancer was breast cancer, followed by gynaecological, bowel, testicular, head and neck, brain cancer and multiple cancer sites.
The review looked only at adult patients who had a false alarm after raising concerns about their symptoms; the effect of a false alarm might be different in patients who are investigated for suspected cancer following cancer screening. More prospective studies are needed, as the majority of included studies were limited by small sample size and retrospective design.