Women’s barriers for contacting general practice when experiencing gynecological cancer symptoms: a population-based study

In countries like Australia, the UK and Denmark the primary care system plays a gatekeeping role, where patients’ access to specialists, hospital care and diagnostic tests needs to be authorised by GPs. For GPs to refer patients with gynecological cancer alarm symptoms for further investigations, the patients must present the symptoms to their GP. Different barriers exist for contacting the GP when experiencing an alarm symptom – ranging from embarrassment, to being afraid of what the GP may find. This Danish nationwide population-based cohort study aimed to examine associations between four common barriers towards contacting the GP regarding specific gynecological cancer alarm symptoms, age, and socioeconomic status. The results indicated that less than 35% of women reporting gynecological cancer alarm symptoms contact their GP. Women with intercourse-related symptoms had the highest proportions of reported barriers, whereas nearly half of those with postmenopausal bleeding did not report barriers. Being too busy was the most commonly reported predefined barrier overall. In general, older women were less likely to report barriers towards GP contact with gynecological alarm symptoms. Lower age and socioeconomic status were significantly associated with higher odds of reporting barriers. Considering the role barriers play in diagnostic and treatment delay, knowledge about barriers towards GP contact is important to improve swift diagnosis. Read full text