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

This systematic review examines factors that contribute to both patient and primary care delays in gynaecological cancers, across the diagnostic pathway. There were 37 publications that met the inclusion criteria. Within this, it was found that patients, unsurprisingly, often didn’t recognise the seriousness of symptoms, which can be misleading, and didn’t seek advice promptly. Some patients were put off consulting because of concerns about having a pelvic examination. GPs can also be misled by presenting symptoms which do not immediately suggest a gynaecological cancer diagnosis, such as gastrointestinal symptoms, and patients may be referred to specialties other than gynaecology. A number of the studies analysed had been conducted after the introduction of clinical guidelines in the UK and Denmark, although these do not appear to have had much impact. The findings of this review highlight that work needs to be carried out to help women recognise symptoms and increase the awareness of gynaecological cancers amongst GPs.

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