Title: COVID-19 Cancer Attitudes and Behaviour Study
Funder: Economic and Social Research Council

Abstract: The overarching aim of the proposed project is to rapidly understand and mitigate the negative impact of COVID-19 on public attitudes towards and preparedness to act in response to possible cancer symptoms, future screening invitations and engagement in health behaviours. Specific project objectives are to: (1) measure the longitudinal impact of COVID-19 and social distancing on cancer attitudes and behaviour in a national population survey; (2) understand in depth the contextual influences on cancer attitudes and behaviour using qualitative methods; (3) assess impact on healthcare service usage and cancer outcomes using Welsh Electronic Health Records; The evidence will be used to provide rapid recommendation to drive tailored public health initiatives for cancer early detection and prevention in the pandemic recovery period. Longer-term, the study will lay the foundations for longer-term research to benchmark future trends and plan cancer prevention, screening and early diagnosis policy to mitigate future global health threats.

Lay abstract: With COVID-19 at the forefront, people may not be aware of the importance of seeking medical help for early signs of cancer or taking up screening, when available, to diagnose cancer sooner. In addition, some people may not want to be referred to a hospital for diagnostic tests due to fear of catching coronavirus in the healthcare setting. COVID-19 may also affect whether people take part in healthy behaviours that can reduce the chances of getting cancer. These factors may lead to more cancers occurring, and more cancers being diagnosed at a late stage when treatment may be less successful. Over 18 months, we will carry out a large study to measure cancer attitudes and behaviours in adults aged 18+ across the UK. We aim to include adults from a range of different backgrounds. Working closely with Cancer Research UK, we will carry out an online survey with at least 3,500 people to ask about any recent symptoms, cancer screening and health behaviours during the UK lockdown period. Survey questions will include the time taken to visit the GP with a range of possible cancer symptoms, attitudes to cancer screening, anxiety about seeking help in the current situation, other barriers to seeking help, health behaviours including smoking, alcohol, diet and physical activity, and preferred ways of receiving public health information. We will also interview by telephone around 30 people who have taken part in the survey to understand their attitudes and behaviours in more detail. The survey and interviews will be repeated with the same people around six months later, to assess any changes in their views and information preferences. Finally, we will link the survey data with medical records available in Wales to assess the number of GP referrals and tests for suspected cancer symptoms, whether people have taken part in cancer screening, whether people who smoke have quit, and the number and stage of new cancers diagnosed. Our study findings will be used to rapidly develop clear public health messages encouraging people to act on the early signs of cancer, take up cancer screening when it becomes available, and engage in healthy behaviours. We think this will help to reduce the negative impact of COVID-19 on cancer outcomes in the longer term.

Research activity codes: 2.5 RESEARCH DESIGN AND METHODOLOGIES (AETIOLOGY)
Health categories: CANCER AND NEOPLASMS;INFECTION