Low, EL; (2014) Gynaecological cancer symptoms: influences on women’s awareness and medical help-seeking. Doctoral thesis , UCL (University College London).

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Abstract

This work stems from an increased effort to improve cancer survival rates through earlier diagnosis, which itself may be achieved through prompt medical help-seeking for symptoms. This thesis focuses on responses to symptoms potentially indicative of a gynaecological cancer; a group of cancers that pose a significant threat to women, and yet are under-represented in the literature. Four studies were conducted. Studies One and Two (n=1392 and n=1000, respectively) were population-based surveys of women, measuring awareness of cervical and ovarian cancer risk factors and symptoms, respectively. Study two also measured hypothetical help-seeking. Study three was a survey of a nationally-representative sample of women (n=911), which explored responses to real symptoms that were potentially indicative of a gynaecological cancer. Building on study three, study four explored responses to symptoms at a deeper level, through in-depth, one-to-one interviews with women who had recently, or were currently, experiencing a symptom potentially indicative of a gynaecological cancer. Awareness of symptom and risk factors for cervical and ovarian cancer was low overall. Women anticipated seeking help promptly for symptoms of ovarian cancer, however, when faced with real symptoms, outside of the context of cancer, help might not be sought as promptly. I found that women with symptoms respond in many different ways. Mapping my findings onto the Model of Pathways to Treatment, I identified a number of different influences which may be more important at the appraisal stage, including what can be expected as part of being a woman and those which may be more important at the help-seeking stage, such as feeling justified in seeking help. More education is needed about the symptoms and risk factors for gynaecological cancers. Further, campaigns encouraging women to seek help for symptoms should include messages which target those variables that may lead women to wait longer before seeking help, such as misattribution of symptoms.

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