Potential impact of health communications to raise awareness of the relative risk of age and cancer: a qualitative study

Abstract

Background: The Cancer Research UK Cancer Awareness Measure Survey (2022) found older age as a risk factor for cancer to be low (around 2-4% across UK nations). However, 89 in 100 cancers are in those aged 50 years and older, and the majority of health-communications are targeted to these higher risk groups. This research aimed to understand the potential impact on health behaviours of communicating messages on relative increased risk of cancer with older age on participant's capability, motivation, and opportunity (COM-B model) in relation to positive early diagnosis health behaviours (body vigilance, intention to take part in cancer screening, preventative measures).

Methods: In this qualitative study, we conducted 60 min semi-structured paired-depth interviews of people aged 25-74 years from across the UK (20 pairs; n=40; age: mean 58·5 years, range 25-74; 19 [47%] men and 21 [53%] women; 27 [67%] White and 13 [33%] from Black or Asian minority ethnic groups). Participants were recruited via a recruitment agency and provided with an incentive of £60 for their time. To assess potential longer-term impact, participants filled a survey 2 weeks later on their views on the messages tested, and on self-reported actions taken as a result of the messages tested. The three different messages tested were rotated. Data were analysed using rapid thematic techniques, two moderators reviewed the data, and a framework analysis style assessed themes against capability, opportunity, and motivation (COM-B model).

Findings: Message 2 was the most preferred, as it was clear and easy to understand. Results suggested that including this messaging in health campaigns could encourage some positive early diagnosis heath behaviours. The post survey identified self-reported behaviour changes in nine (23%) of the 40 participants and sustained intentions in 29 (73%). Results overlayed with COM-B, identified messaging could support behaviour change by increasing awareness (psychological capability), providing a social cue (social opportunity), and encouraging emotions related to not wanting to get cancer or that they should be doing specific behaviours (reflective motivation).

Interpretation: Findings suggest communicating this message might have a positive effect on help-seeking behaviours in older adults (age ≥50 years). However, considerations include ensuring that the message is clear and understandable and that it doesn't induce fear. Although this study design allowed for more in-depth exploration, results are limited due to the small sample size.

Funding: Cancer Research UK.