Delays in seeking medical care for potential cancer symptoms

Early cancer detection significantly improves health outcomes; however, a substantial proportion of diagnoses occur after the symptom onset, outside population-based screening programmes. Understanding delays in help-seeking behaviour is therefore essential to elucidate how symptoms are interpreted and which factors influence the decision to consult a healthcare professional. A nationwide study was conducted among the Spanish population aged 18 to 80 years using an online self-administered survey. The final sample consisted of 2,042 respondents, stratified by autonomous community and weighted by sex and age. Recognition of cancer warning signs was high, with 10 out of 17 symptoms identified by more than 70% of respondents. Among symptoms experienced during the previous 12 months, unexplained fatigue was the most frequently reported (32.5%), followed by changes in bowel habits (20.2%) and shortness of breath (19.9%). These symptoms generated high levels of concern, particularly among women, with notable sex differences for certain symptoms, such as coughing up blood (22.5 percentage points higher concern among women than men). Overall, 60.8% of participants experienced at least one warning sign, among whom 15.4% reported taking no action. Of those who took some action, such as consulting a healthcare professional or taking medication, 18.7% delayed consultation for more than one month or did not seek medical care. The main barriers identified were lack of time to attend medical appointments (18.8%), fear of diagnosis (17.1%), and reassurance after searching for information online (14.5%). Delays in help-seeking reflect a complex interaction between symptom awareness and interpretation, emotional responses and social context. These findings highlight the need for health promotion strategies that go beyond information provision, incorporating psychosocial and contextual determinants to encourage timely and equitable medical consultation for potential cancer symptoms.

Key messages

• Despite high awareness of cancer warning signs, a substantial proportion of adults delay or avoid seeking medical care after symptom onset, often due to time constraints, fear, and online reassurance.

• Help‑seeking delays are driven by a complex interplay of symptom awareness, interpretation, emotions, and social context, highlighting the need for health promotion beyond information alone.