Patient and primary care delays in the diagnostic pathway of gynaecological cancers

a systematic review of influencing factors

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Abstract

Background Gynaecological cancers are the second most common female cancer type, with survival rates in the UK lower than in many comparable countries. A potentially important factor in the UK’s poorer cancer outcomes is diagnostic delay; gynaecological cancers are the cancer type most likely to be affected by less timely diagnosis. Aim To examine current evidence for factors that contribute to patient and primary care delays in the diagnostic pathway of gynaecological cancer. Design and setting A systematic review of the available literature. Method PRISMA guidelines were followed. MEDLINE and Embase databases and the Cochrane Library were searched using three terms: primary care; gynaecological cancer; and delay. Citation lists of all identified articles were searched. Two authors independently screened the titles, abstracts, and full texts of publications. Data extraction was performed by one author and quality assured by a second reviewer in a 20% sample of selected articles. Synthesis was narrative. Results A total of 1253 references was identified, of which 37 met the inclusion criteria. Factors associated with delayed diagnosis were categorised as either patient factors (patient demographics, symptoms or knowledge, and presentation to the GP) or primary care factors (doctor factors: patient demographics, symptoms or knowledge, and referral process); and system factors (such as limited access to investigations). Conclusion Delayed diagnosis in the patient and primary care intervals of the diagnostic journey of gynaecological cancer is complex and multifactorial. This review identifies areas of future research that could lead to interventions to enable prompter diagnosis of gynaecological cancers.
Original languageEnglish
Pages (from-to)106-111
Number of pages6
JournalBritish Journal of General Practice
Volume69
Issue number679
Early online date16 Jan 2019
DOIs
Publication statusPublished - Feb 2019

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Primary Health Care
Patient Care
Neoplasms
Delayed Diagnosis
Demography
Second Primary Neoplasms
MEDLINE
Libraries
Publications
Referral and Consultation
Survival Rate
Databases
Guidelines

Keywords

  • delayed diagnosis
  • gynaecological cancer
  • primary health care
  • systematic review
  • Delayed diagnosis
  • Primary health care
  • Gynaecological cancer
  • Systematic review

ASJC Scopus subject areas

  • Family Practice

Cite this

@article{4ec49876537440c19e42fcce84e609fe,
title = "Patient and primary care delays in the diagnostic pathway of gynaecological cancers: a systematic review of influencing factors",
abstract = "Background Gynaecological cancers are the second most common female cancer type, with survival rates in the UK lower than in many comparable countries. A potentially important factor in the UK’s poorer cancer outcomes is diagnostic delay; gynaecological cancers are the cancer type most likely to be affected by less timely diagnosis. Aim To examine current evidence for factors that contribute to patient and primary care delays in the diagnostic pathway of gynaecological cancer. Design and setting A systematic review of the available literature. Method PRISMA guidelines were followed. MEDLINE and Embase databases and the Cochrane Library were searched using three terms: primary care; gynaecological cancer; and delay. Citation lists of all identified articles were searched. Two authors independently screened the titles, abstracts, and full texts of publications. Data extraction was performed by one author and quality assured by a second reviewer in a 20{\%} sample of selected articles. Synthesis was narrative. Results A total of 1253 references was identified, of which 37 met the inclusion criteria. Factors associated with delayed diagnosis were categorised as either patient factors (patient demographics, symptoms or knowledge, and presentation to the GP) or primary care factors (doctor factors: patient demographics, symptoms or knowledge, and referral process); and system factors (such as limited access to investigations). Conclusion Delayed diagnosis in the patient and primary care intervals of the diagnostic journey of gynaecological cancer is complex and multifactorial. This review identifies areas of future research that could lead to interventions to enable prompter diagnosis of gynaecological cancers.",
keywords = "delayed diagnosis, gynaecological cancer, primary health care, systematic review, Delayed diagnosis, Primary health care, Gynaecological cancer, Systematic review",
author = "Pauline Williams and Peter Murchie and Christine Bond",
note = "Funding This work was funded by an NHS Education for Scotland Clinical Academic Fellowship.",
year = "2019",
month = "2",
doi = "10.3399/bjgp19X700781",
language = "English",
volume = "69",
pages = "106--111",
journal = "The British Journal of General Practice",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",
number = "679",

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T1 - Patient and primary care delays in the diagnostic pathway of gynaecological cancers

T2 - a systematic review of influencing factors

AU - Williams, Pauline

AU - Murchie, Peter

AU - Bond, Christine

N1 - Funding This work was funded by an NHS Education for Scotland Clinical Academic Fellowship.

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N2 - Background Gynaecological cancers are the second most common female cancer type, with survival rates in the UK lower than in many comparable countries. A potentially important factor in the UK’s poorer cancer outcomes is diagnostic delay; gynaecological cancers are the cancer type most likely to be affected by less timely diagnosis. Aim To examine current evidence for factors that contribute to patient and primary care delays in the diagnostic pathway of gynaecological cancer. Design and setting A systematic review of the available literature. Method PRISMA guidelines were followed. MEDLINE and Embase databases and the Cochrane Library were searched using three terms: primary care; gynaecological cancer; and delay. Citation lists of all identified articles were searched. Two authors independently screened the titles, abstracts, and full texts of publications. Data extraction was performed by one author and quality assured by a second reviewer in a 20% sample of selected articles. Synthesis was narrative. Results A total of 1253 references was identified, of which 37 met the inclusion criteria. Factors associated with delayed diagnosis were categorised as either patient factors (patient demographics, symptoms or knowledge, and presentation to the GP) or primary care factors (doctor factors: patient demographics, symptoms or knowledge, and referral process); and system factors (such as limited access to investigations). Conclusion Delayed diagnosis in the patient and primary care intervals of the diagnostic journey of gynaecological cancer is complex and multifactorial. This review identifies areas of future research that could lead to interventions to enable prompter diagnosis of gynaecological cancers.

AB - Background Gynaecological cancers are the second most common female cancer type, with survival rates in the UK lower than in many comparable countries. A potentially important factor in the UK’s poorer cancer outcomes is diagnostic delay; gynaecological cancers are the cancer type most likely to be affected by less timely diagnosis. Aim To examine current evidence for factors that contribute to patient and primary care delays in the diagnostic pathway of gynaecological cancer. Design and setting A systematic review of the available literature. Method PRISMA guidelines were followed. MEDLINE and Embase databases and the Cochrane Library were searched using three terms: primary care; gynaecological cancer; and delay. Citation lists of all identified articles were searched. Two authors independently screened the titles, abstracts, and full texts of publications. Data extraction was performed by one author and quality assured by a second reviewer in a 20% sample of selected articles. Synthesis was narrative. Results A total of 1253 references was identified, of which 37 met the inclusion criteria. Factors associated with delayed diagnosis were categorised as either patient factors (patient demographics, symptoms or knowledge, and presentation to the GP) or primary care factors (doctor factors: patient demographics, symptoms or knowledge, and referral process); and system factors (such as limited access to investigations). Conclusion Delayed diagnosis in the patient and primary care intervals of the diagnostic journey of gynaecological cancer is complex and multifactorial. This review identifies areas of future research that could lead to interventions to enable prompter diagnosis of gynaecological cancers.

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