Journal of Education and Health Promotion

Screening for red flag symptoms of cancer: A community‑based cross‑sectional study from urban Puducherry, India

Document Type : Original Article

Authors

. Manikandanesan Sakthivel
. Yuvaraj Krishnamoorthy
. Gokul Sarveswaran
. R. Jayalakshmy
. Shanthosh Priyan
. N. Bharathnag
Abstract
BACKGROUND: Patients with cancer often delay seeking medical advice in developing
countries. In India, only 20%–30% of cancers are being diagnosed in Stages I and II.
Screening for red flag symptoms of cancer can be used to identify high‑risk individuals in the
community.
METHODOLOGY: A community‑based cross‑sectional study was conducted in February 2017
among 302 participants in one of the service areas of Jawaharlal Institute of Postgraduate Medical
Education and Research urban health center selected by universal sampling. Data on the presence
of red flag symptoms of cancer (persistent cough, persistent change in bowel/bladder habits,
nonhealing ulcer, persistent difficulty in swallowing, unexplained weight loss, unexplained lump,
persistent unexplained pain, unexplained bleeding, and change in the appearance of mole) and
presence of risk factors were collected through interviews. The collected data were entered using
EpiData version 3.0.
RESULTS: The mean (standard deviation) age of the study participants was 44 (11) years and 50.6%
of them were male. At least one red flag symptom of cancer was present in 22 (7.3%) individuals;
9 (2.8%) had unexplained pain, 4 (1.3%) had change in bowel habits, 4 (1.3%) had change in bladder
habits, 3 (1%) had cough, 3 (1%) had nonhealing ulcer, 2 (0.6%) had unexplained bleeding, 1 (0.3%)
had difficulty in swallowing, 1 (0.3%) had weight loss, 1 (0.3%) had lump, and 1 (0.3%) had change
in the appearance of mole.
CONCLUSION: Screening for red flag symptoms of cancer is an easy tool that can be used in the community
to identify high‑risk individuals, which will facilitate early diagnosis of cancer.

Keywords

Cancer
community
red flag symptoms
screening
urban
1. WHO | Cancer. WHO. Available from: http://www.who.
int/mediacentre/factsheets/fs297/en/. [Last accessed on
2018 Apr 12].
2. Global Burden of Disease Cancer Collaboration, Fitzmaurice C,
Dicker D, Pain A, Hamavid H, Moradi‑Lakeh M, et al. The global
burden of cancer 2013. JAMA Oncol 2015;1:505‑27.
3. Mallath MK, Taylor DG, Badwe RA, Rath GK, Shanta V,
Pramesh CS, et al. The growing burden of cancer in India:
Epidemiology and social context. Lancet Oncol 2014;15:e205‑12.
4. Ernst & Young: Call for Action: Expanding Cancer
Care in India; July, 2015. Available from: http://www.
ey.com/Publication/vwLUAssets/EY‑Call‑for‑ action‑
expanding‑cancer‑care‑in‑india/$FILE/EY‑Call‑for‑ action‑
expanding‑cancer‑care‑inindia.pdf. [Last accessed on
2018 Apr 12].
5. World Health Organization. Guide to Early Cancer Diagnosis;
2017. Available from: http://www.apps.who.int/iris/bitstrea
m/10665/254500/1/9789241511940‑eng.pdf. [Last accessed on
2018 Apr 12].
6. Stewart BW, Wild CP. World Cancer Report 2014. Lyon:
International Agency for Research on Cancer/World Health
Organization; 2014.
7. Sankaranarayanan R, Ramadas K, Qiao YL. Early detection of
cancer in primary care in less‑developed countries. Cancer Control
2013;20:69‑72.
8. Hippisley‑Cox J, Coupland C. Symptoms and risk factors to
identify women with suspected cancer in primary care: Derivation
and validation of an algorithm. Br J Gen Pract 2013;63:e11‑21.
9. Hippisley‑Cox J, Coupland C. Symptoms and risk factors to
identify men with suspected cancer in primary care: Derivation
and validation of an algorithm. Br J Gen Pract 2013;63:e1‑10.
10. Miller AB, World Health Organization. Cervical Cancer Screening
Programmes: Managerial Guidelines/A. B. Miller. Geneva: World
Health Organization; 1992.
11. Lauritsen JM, Bruus M. EpiData Entry 3.01. A Comprehensive
Tool for Validated entry and Documentation of Data. Odense
Denmark: The EpiData Association; 2008.
12. Svendsen RP, Støvring H, Hansen BL, Kragstrup J,
Søndergaard J, Jarbøl DE, et al. Prevalence of cancer alarm
symptoms: A population‑based cross‑sectional study. Scand J
Prim Health Care 2010;28:132‑7.
13. Whitaker KL, Scott SE, Winstanley K, Macleod U, Wardle J.
Attributions of cancer ‘alarm’ symptoms in a community sample.
PLoS One 2014;9:e114028.
14. Jones R, Charlton J, Latinovic R, Gulliford MC. Alarm symptoms
and identification of non‑cancer diagnoses in primary care: Cohort
study. BMJ 2009;339:b3094.
Journal of Education and Health Promotion
Volume 8, Issue 12
December 2018
Pages 1-5

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us