Exploring communication during the journey from noticing bodily changes to a diagnosis of endometrial cancer

Cook, Catherine; Brunton, Margaret; Pukepuke, Tepora; Tan, Ai Ling

doi:10.1111/jocn.14173

Cited by 12 publications

(35 citation statements)

References 46 publications

(76 reference statements)

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“…38 Interviews were conducted within 9 months of diagnosis, with the authors finding participants had limited knowledge of oesophageal cancer, initially appraising symptoms in the context of normal bodily functions until symptoms changed or worsened. This reflects findings in the current study, and resonates with research across other cancers, where subtle or intermittent symptoms are often not considered serious [25][26][27][39][40][41] and initial bodily changes are attributed to benign causes. 39,[42][43][44][45] Another study explored the use of over-the-counter medication in Scotland with 25 patients diagnosed with lung (n = 14), colorectal (n = 4), or oesophago-gastric (n = 7) cancer in the preceding 12 months.…”

Section: Comparison With Existing Literaturesupporting

confidence: 81%

Patient symptom experience prior to a diagnosis of oesophageal or gastric cancer: a multi-methods study

et al. 2020

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BackgroundLate stage diagnosis of oesophageal and gastric cancer is common, which limits treatment options and contributes to poor survival.AimTo explore patients' understanding, experience and presentation of symptoms before a diagnosis of oesophageal or gastric cancer.Design & settingBetween May 2016 and October 2017, all patients newly diagnosed with oesophageal or gastric cancer were identified at weekly multidisciplinary team meetings at two large hospitals in England. A total of 321 patients were invited to participate in a survey and secondary care medical record review; 127 (40%) participants responded (102 patients had oesophageal cancer and 25 had gastric cancer). Of these, 26 participated in an additional face-to-face interview.MethodSurvey and medical record data were analysed descriptively. Interviews were analysed using thematic analysis, informed by the Model of Pathways to Treatment.ResultsParticipants experienced multiple symptoms before diagnosis. The most common symptom associated with oesophageal cancer was dysphagia (n = 66, 65%); for gastric cancer, fatigue or tiredness (n = 20, 80%) was the most common symptom. Understanding of heartburn, reflux and indigestion, and associated symptoms differed between participants and often contrasted with clinical perspectives. Bodily changes attributed to personal and/or lifestyle factors were self-managed, with presentation to primary care prompted when symptoms persisted, worsened, or impacted daily life, or were notably severe or unusual. Participants rarely presented all symptoms at the initial consultation.ConclusionThe patient interval may be lengthened by misinterpretation of key terms, such as heartburn, or misattribution or non-recognition of important bodily changes. Clearly defined symptom awareness messages may encourage earlier help-seeking, while eliciting symptom experience and meanings in primary care consultations could prompt earlier referral and diagnosis.

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Section: Comparison With Existing Literaturesupporting

confidence: 81%

Patient symptom experience prior to a diagnosis of oesophageal or gastric cancer: a multi-methods study

et al. 2020

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“…Half of the included studies identified general health literacy as a barrier to accessing care for AUB [12,15,19,[21][22][23]. One American study in 2010 noted the variability in 71 women in the perception of heavy and irregular bleeding [19].…”

Section: Theme 1: Health Literacymentioning

confidence: 99%

“…In a study of women previously diagnosed and treated for endometrial cancer [22], general uterine health and Pap smears were confused. Many women were upset that their routine cervical smear did not pick up EC:…”

Section: Theme 1: Health Literacymentioning

confidence: 99%

“…"It disappointed me … as long as you go for a smear test your fine" [22] This was echoed in a UK study, where eight of eleven women had considered AUB as a risk of cancer, but reassured themselves that a normal smear meant this was not the cause [13]. Whilst most women were aware of the need for routine Pap smears, confusion meant that women did not receive or perceive the correct information.…”

Section: Theme 1: Health Literacymentioning

confidence: 99%

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Barriers to seeking consultation for abnormal uterine bleeding: systematic review of qualitative research

2020

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Background: Although Abnormal Uterine Bleeding (AUB) can have serious medical consequences and significantly impacts daily life, the overall trend is that most women do not seek care for these symptoms. The objective of this review was to synthesise factors impeding women's access care for AUB. Methods: Systematic literature review of qualitative studies (interview and focus group) regarding the lived in experiences of women with abnormal menstrual symptoms, followed by a thematic analysis of these studies. We screened CINAHL, SCOPUS, ProQuest, OVID and Pubmed for qualitative studies. Studies were assessed using the Clinical Appraisal Skills Programme checklist and thematic synthesis was used to develop themes from the findings of the studies. Results: The review yielded 12 studies that satisfied the inclusion criteria. Three themes were developed that described barriers for women seeking care for AUB: health literacy (understanding of normal periods, role of cervical Pap smears and lack of access to appropriate information), taboo/normalisation (fear and embarrassment of symptoms, prioritising others) and health care provider (lack of accessible and trusted female GPs and poor experiences with GPs). Conclusions: For 20 years women have consistently reported poor experiences in accessing care for AUB. The findings from our review indicate that drivers to impeding access are multiple; therefore any approaches to improve access will need to be multi-levelfrom comprising local sociocultural considerations to improved GP training.

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“…Consequently, while the risk of endometrial cancer is age-dependent (around 90% of the cases affect women above 45 years), the global rise in obesity increase the incidence in women under the age of 40 (Cook et al 2018;Reeves et al 2007).…”

Section: Introductionmentioning

confidence: 99%

“But this is a good cancer:” Patient perceptions of endometrial cancer in Denmark

Sidenius

Manderson

Mogensen

et al. 2018

Journal of Clinical Nursing

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Exploring communication during the journey from noticing bodily changes to a diagnosis of endometrial cancer

Cited by 12 publications

References 46 publications

Patient symptom experience prior to a diagnosis of oesophageal or gastric cancer: a multi-methods study

Patient symptom experience prior to a diagnosis of oesophageal or gastric cancer: a multi-methods study

Barriers to seeking consultation for abnormal uterine bleeding: systematic review of qualitative research

“But this is a good cancer:” Patient perceptions of endometrial cancer in Denmark

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