Katriina Whitaker is Lead for Cancer Care in the School of Health Sciences at the University of Surrey. Katriina was awarded a prestigious Cancer Research UK postdoctoral research fellowship (2012-2015) to explore cancer symptom appraisal in everyday life. Her ongoing programme of work focuses on early diagnosis and cancer, with a particular interest in healthcare-seeking and health inequalities.
Katriina is a Chartered Psychologist and was made a Fellow of the British Psychological Society in 2017. She is an expert panel member for Cancer Research UK's Early Diagnosis Review Panel and a member of the National Cancer Research Institute (NCRI) Primary Care Clinical Studies Group. She also sits on Editorial Boards for the European Journal of Cancer Care and Psycho-Oncology.
- Early diagnosis and cancer
- Cancer knowledge, attitudes and beliefs
- Symptom perception
- Health psychology
- Health inequalities
Katie Robb (University of Glasgow)
Jo Waller (University College London)
Georgia Black (University College London)
Peter Vedsted (Aarhus University, Denmark)
Yoryos Lyratzopoulos (University College London, University of Cambridge)
Una Macleod (Hull York Medical School)
Fiona Walter (University of Cambridge)
Indicators of esteem
February 2017- current. Fellow of the British Psychological Society (BPS)
May 2016-current. Member of the Psycho-Oncology Journal Affiliate Editorial Board
February 2016-current. Member of the National Cancer Research Institute (NCRI) Primary Care Clinical Study Group (CSG).
August 2015-current: Member of the National Cancer Research Institute (NCRI) Primary Care Early Diagnosis sub-group.
April 2015-current: Expert Panel Member, Early Diagnosis Panel of Population Research Committee, Cancer Research UK.
April 2015-current: Committee member of IPOS Communications and Publications Committee.
March 2015-current: Editorial Board Member, European Journal of Cancer Care.
November 2014-current: Honorary Senior Research Fellow, Epidemiology and Public Health, University College London.
November 2013-current: Scholar, Editorial Board, British Journal of Health Psychology
Jan 2012-current: Chartered member (CPsychol) of British Psychological Society (BPS).
PhD, MSc and BSc student supervision
Module lead for Cancer in Society
von Wagner, C., Good, A., Whitaker, K.L., Wardle, J. (2011). Psychosocial determinants of socioeconomic inequalities in cancer screening participation: A conceptual framework. Epidemiologic Reviews, 33, 135-147.
Whitaker, K.L., Scott, S., Winstanley, K., Macleod, U., Wardle, J. (2014). Attributions of cancer ‘alarm’ symptoms in a community sample. PLOS One, 9 (12):e114028, DOI: 10.1371/journal.pone.0114028
Whitaker, K.L., Macleod, U., Winstanley, K., Scott, S., Wardle, J. (2015). Help-seeking for cancer ‘alarm’ symptoms: a qualitative interview study. British Journal of General Practice, 65(631); e96-e105.
Whitaker, K.L., Scott, S., Wardle, J. (2015) Applying symptom appraisal models to understand socio-demographic differences in responses to possible cancer symptoms: A research agenda. British Journal of Cancer, 112, Suppl 1: S27-S34, doi: 10.1038/bjc.2015.39.
Whitaker, K.L., Friedemann Smith, C., Winstanley K., Wardle, J. (2016). What prompts help-seeking for cancer ‘alarm’ symptoms? A primary care based survey. British Journal of Cancer, 114, 334-339, doi: 10.1038/bjc.2015.445
Davies, H., Marcu, A., Vedsted, P., Whitaker, K.L (2018). Is lower symptom recognition associated with socioeconomic inequalities in help-seeking for potential breast cancer symptoms? Psycho-Oncology, 27 (2), 626-632.
Lower socioeconomic status (SES) is associated with a higher risk of late-stage cancer diagnosis. A number of explanations have been advanced for this, but one which has attracted recent attention is lower patient knowledge of cancer warning signs, leading to delay in help-seeking. However, although there is psychometric evidence of SES differences in knowledge of cancer symptoms, no studies have examined differences in ?cancer suspicion? among people who are actually experiencing a classic warning sign.
A ?health survey? was mailed to 9771 adults (~50 years, no cancer diagnosis) with a symptom list including 10 cancer ?warning signs?. Respondents were asked if they had experienced any of the symptoms in the past 3 months, and if so, were asked ?what do you think caused it?? Any mention of cancer was scored as ?cancer suspicion?. SES was indexed by education.
Nearly half the respondents (1732/3756) had experienced a ?warning sign?, but only 63/1732 (3.6%) mentioned cancer as a possible cause. Lower education was associated with lower likelihood of cancer suspicion: 2.6% of respondents with school-only education versus 7.3% with university education suspected cancer as a possible cause. In multivariable analysis, low education was the only demographic variable independently associated with lower cancer suspicion (odds ratio (OR) = 0.34, confidence interval (CI): 0.20?0.59).
Levels of cancer suspicion were low overall in this community sample, and even lower in people from less educated backgrounds. This may hinder early symptomatic presentation and contribute to inequalities in stage at diagnosis.
1724). Over half the respondents (915/1724; 53%) had experienced an 'alarm' symptom, and 20 (2%) cited cancer as a possible cause. Cancer attributions were highest for 'unexplained lump'; 7% (6/87). Cancer attributions were lowest for 'unexplained weight loss' (0/47). A higher proportion (375/1638; 23%) were concerned their symptom might be 'serious', ranging from 12% (13/112) for change in a mole to 41% (100/247) for unexplained pain. Just over half had contacted their doctor about their symptom (59%), although this varied by symptom. Alarm symptoms were appraised as more serious than non-alarm symptoms, and were more likely to trigger help-seeking. CONCLUSIONS: Consistent with retrospective reports from cancer patients, 'alarm' symptoms experienced in daily life were rarely attributed to cancer. These results have implications for understanding how people appraise and act on symptoms that could be early warning signs of cancer.
We examined associations between different chronic morbidities and help-seeking for possible cancer symptoms.
Postal survey of individuals aged>50 years in England. Participants could report prior morbidities in respect of 12 pre-defined conditions. Among patients experiencing possible cancer symptoms we examined associations between specific morbidities and self-reported help-seeking (i.e. contacted versus not contacted a GP) for each alarm symptom using regression analyses.
Among 2042 respondents (42% response rate), 936 (46%) recently experienced one of 14 possible cancer symptoms considered in our analysis. Of them, 80% reported one or more morbidities, most frequently hypertension/hypercholesterolemia (40%), osteomuscular (36%) and heart diseases (21%). After adjustment for socio-demographic characteristics, patients with hypertension/hypercholesterolemia were more likely to report help-seeking for possible cancer symptoms, such as unexplained cough (OR=2.0; 95%CI 1.1-3.5), pain (OR=2.2; 95%CI 1.0-4.5) and abdominal bloating (OR=2.3; 95%CI 1.1-4.8). Urinary morbidity was associated with increased help-seeking for abdominal bloating (OR=5.4; 95%CI 1.2-23.7) or rectal bleeding (OR=5.8; 95%CI 1.4-23.8). In contrast, heart problems reduced help-seeking for change in bowel habits (OR=0.4; 95%CI 0.2-1.0).
Comorbidities are common and may facilitate help-seeking for possible cancer symptoms, but associations vary for specific symptom-comorbidity pairs. The findings can contribute to the design of future cancer symptom awareness campaigns.
Background: Presenting to primary care with potential cancer symptoms is contingent on one?s ability to recognize potentially serious symptoms. We investigated differences between smokers and non-smokers in symptoms experienced, awareness and consulting of potential respiratory, head and neck cancer symptoms.
Methods: Smokers and non-smokers aged over 50 from Yorkshire general practice lists were sent a postal questionnaire asking about symptoms, consulting and awareness of cancer symptoms. Data were analysed using STATA14.
Results: Response rate after one reminder was 30.5% (1205/3954). Smoking status was associated with experience of cough (p
Conclusion: Our findings suggest that current smokers are more likely to experience cough, breathlessness and tiredness, but are less likely to consult for cough than never-smokers. To increase cancer awareness and promote consulting among smokers, innovative interventions improving symptom recognition and empowering smokers to seek help are required.
Socioeconomic inequalities in recognising signs and symptoms of cancer may result in inequalities in timely help-seeking and subsequent prognosis of breast cancer. We explored the mediating role of symptom attribution and concern on the relationship between level of education and help-seeking for potential breast cancer symptoms.
Women aged e47 years (n=961) were purposively recruited (by education) to complete an online vignette-based survey that included nipple rash and axillary lump (in separate vignettes) as potential symptoms of breast cancer. Women completed questions relating to medical help-seeking (Yes/No), cancer attribution, symptom concern, cancer avoidance, family history and demographics.
Women with low education and mid-education attributed nipple rash less often to cancer (26% and 27% mentioned cancer) than women with a degree or higher (40%). However, women with a degree or higher (63%) or mid-education (64%) were less likely to anticipate seeking help for the nipple rash than women with no formal qualifications (73%). This association was statistically significant in the 60-69 year old age group. There was no significant association between education and help-seeking for axillary lump. Mediation analysis adjusting for potential confounders confirmed that the association between education and help-seeking for nipple rash was fully mediated by symptom concern.
Socioeconomic inequalities in stage at diagnosis and survival of breast cancer may not always be explained by lower likelihood of suspecting cancer and subsequent impact on help-seeking. Reducing inequalities in stage at diagnosis will involve understanding a broader range of bio-psycho-social factors (e.g. comorbidities, healthcare system factors).