It might have helped the Victorians build an empire, but having a stiff upper lip could be putting Britons in mortal danger from cancer, researchers claim.
A study by international experts suggests that British stoicism may help explain differences in cancer survival between the UK and other high-income countries.
People in Britain were said to be more likely than others to avoid bothering their doctor over symptoms they find embarrassing and time-wasting.
As a result, cancer sufferers were less likely to be treated at an early stage when there is a greater chance of a cure.
Dr Lindsay Forbes, from King's College London, one of the lead authors of the research published in the British Journal of Cancer, said: "The UK stood out in this study. A high proportion of people said that not wanting to waste the doctor's time and embarrassment might stop them going to the doctor with a symptom that might be serious.
"The traditional British 'stiff upper lip' could be preventing people from seeing their doctor."
The scientists, from a collaboration called the International Cancer Benchmarking Partnership, previously compared cancer survival in a number of developed countries including the UK.
For lung, breast, bowel and ovarian cancers diagnosed between 1995 and 2007, Australia, Canada, Sweden and Norway had the best survival rates.
Denmark and the UK had the lowest, despite all the countries having similarly good cancer registration systems and access to health care.
One year survival for people with lung cancer was 30% in the UK compared with 44% in Sweden.
A lump or swelling anywhere on your body needs checking out
AXA’s research found that 79% of people were able to correctly identify breast lumps as a potential indicator of cancer. But a lump or swelling in any part of the body, including the armpit, neck, abdomen, groin or chest area, is worth having checked by a doctor.
Talk about your toilet habits
Diarrhoea or changes in bowel habits are most likely to be caused by a stomach bug or eating something that disagrees with you. But if you’re noticing changes that have lasted more than a few days, for example if your bowel movements are looser for three weeks or more, or you notice any blood when you’ve been to the toilet, then make an appointment to get it checked out.
Sores and ulcers should disappear quickly – investigate them if they don’t
A lot of people get mouth ulcers when their immune system is low or they’re stressed. Generally they’re nothing to worry about and, as the lining of the mouth regenerates itself every couple of weeks, shouldn’t last long. But any ulcer that hasn’t healed after three weeks merits attention from your doctor or dentist. The same goes for any sore or spot that lasts for several weeks without healing – get it checked by a doctor.
Difficult passing urine – not just an inevitable consequence of age
Many men find it more difficult to pass urine as they get older, needing to go more often or urgently or being unable to go when they need to. These problems are usually caused by an enlarged prostate, which is a common condition that is not in itself cause for concern. But occasionally these symptoms can be a sign of prostate cancer – either way, men experiencing these symptoms should see their GP. Similarly, while urinary tract infections are the most likely cause of women having pain or difficulty passing urine, this should pass relatively quickly. If it doesn’t, then any sudden urges to pass urine or the need to go more often should be discussed with your doctor.
Lost weight without dieting?
It’s natural for most people’s weight to fluctuate over time. But if you haven’t instigated any changes in your diet or exercise regime and have obviously lost weight, then talk to your doctor. And if you’re experiencing heavy night sweats you should seek medical advice – these don’t always have a sinister cause, and can be brought about by certain infections or medications, but they’re worth checking.
Coughing up blood needs to be checked out
If you’ve coughed up any blood, you should see your doctor, regardless of the amount of blood or frequency. It can be a sign of lung cancer, so needs to be checked out.
Coughs and sore throats
Most of us will experience coughs or croaky voices at some point, normally when we’ve had a cold. But as with many other changes to your body, anything that hasn’t gone away after three weeks or so should be investigated.
Educate yourself on what to look out for
AXA’s research found women were more likely than men to identify key cancer warning signs, including breast lumps, changes in bowel habits and irregular moles. But for both men and women, ensuring you’re aware of symptoms to keep an eye out for is important. Knowledge is power: understanding what you’re looking for means you can any changes checked out quickly.
Know your own body
AXA’s research found only 6% of men and 3% of women check their bodies daily for anything unusual. But understanding what’s normal for your own body is essential if you’re to spot when anything has changed. If you do notice changes that are persisting for a long time, or causing you pain and discomfort, then see your GP.
Don’t put off seeing the doctor!
A sizeable 61% of people AXA spoke to admitted they’d delayed seeing their doctor when they spotted changes that could be potential flags for cancer. But early detection of any problems can make a huge difference if any treatment is then needed. Similarly, if changes are harmless your doctor will be able to reassure you. Overall, the sooner you go to see your GP, the better.
The new study, jointly conducted with the charity Cancer Research UK and pollsters Ipsos Mori, set out to learn whether cultural factors could explain the differences.
Researchers surveyed 19,079 men and women aged 50 and older in the six countries.
They found little difference across borders in people's awareness of cancer symptoms and their views about the chances of surviving the disease.
But when the scientists looked at barriers to seeing the doctor with early cancer symptoms, the British stiff upper lip came to the fore.
Being worried about wasting a doctor's time was especially common in the UK, where it was reported by 34% of those surveyed. In contrast, just 9% of Swedes were concerned about time-wasting in the surgery.
Embarrassment about going to the doctor with a potentially serious symptom was most common in Britain (15%) and least common in Denmark (6%).
However, ignorance also had a part to play. Awareness that cancer risk increased with age was lowest in Canada (13%) and the UK (14%) and highest in Sweden (38%).
Dr Forbes said: "We need to support people to make the right decisions about their health and increase awareness of the age-related risk."
Professor Jane Wardle, from University College London, said: "In the UK, it's important to understand more about how people make the decision to go to their GP with possible cancer symptoms, and how they interact with their GP, to identify the best ways to reduce barriers to early presentation."
Sara Hiom, director of patient engagement and early diagnosis at Cancer Research UK, said it was encouraging that Britons appeared to be knowledgeable about cancer symptoms and had positive beliefs about cancer outcomes.
But she added: "The research highlights that people in the UK are more worried and embarrassed about seeing their doctor with a symptom that might be serious compared to those in other countries.
"Cancer Research UK and others are working hard to understand and address these potential barriers to early presentation and encourage people to tell their doctor if they have noticed something different about their body. More work also needs to be done to tackle the poor awareness that cancer risk increases with age."