title: Increasing awareness of gynaecological cancer symptoms: a GP perspective.
abstract: BACKGROUND
  In the UK there has been an effort, through the National Awareness and Early Diagnosis Initiative (NAEDI), to increase early stage diagnoses and ultimately cancer survival. Encouraging early symptom presentation through awareness-raising activities in primary care is one method to achieve this goal. Understanding GPs' views about this type of activity, however, is crucial prior to implementation.
  
  
  OBJECTIVE
  To describe GPs' attitudes to raising public awareness of gynaecological cancers, and their views about the potential impact on primary care services.
  
  
  METHODS
  An online survey with a convenience sample recruited from 1860 UK general practices.
  
  
  METHODS
  An invitation was emailed to GPs via practice managers and included a weblink to a draft education leaflet and an online survey about the impact of sending a leaflet giving information about symptoms associated with gynaecological cancers to all women on GPs' lists. Participants could offer additional free text comments which were coded using content analysis.
  
  
  RESULTS
  A total of 621 GPs participated. Most (77%, 477) felt that raising awareness of cancers was important. Only half (50%, 308), however, indicated that they would distribute such a leaflet from their practice. Barriers to implementation included concerns about financial costs; emotional impact on patients; increased demand for appointments and diagnostic services, such as ultrasound.
  
  
  CONCLUSIONS
  GPs were generally positive about an intervention to improve patients' awareness of gynaecological cancers, but had concerns about increasing rates of presentation. There is a need for research quantifying the benefits of earlier diagnosis against resource costs such as increased consultations, investigations, and referrals.
authors.affiliation: Research associate, Health Services Research, School of Health Sciences, City University, London.
authors.forename: Ruth E C
authors.initials: RE
authors.lastname: Evans
authors.affiliation: Research fellow in epidemiology, Health Behaviour Research Centre, Department of Epidemiology and Public Health;
authors.forename: Melanie
authors.initials: M
authors.lastname: Morris
authors.affiliation: Health Services Research, School of Health Sciences, City University, London.
authors.forename: Mandeep
authors.initials: M
authors.lastname: Sekhon
authors.affiliation: Research Department of Primary Care and Population Health, University College London, London.
authors.forename: Marta
authors.initials: M
authors.lastname: Buszewicz
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Walter
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health;
authors.forename: Jo
authors.initials: J
authors.lastname: Waller
authors.affiliation: Health Services Research, School of Health Sciences, City University, London.
authors.forename: Alice E
authors.initials: AE
authors.lastname: Simon
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001364:Awareness; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D058005:General Practitioners / Q000458:organization & administration*; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D019538:Health Care Surveys; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015588:Observer Variation; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D011320:Primary Health Care / Q000458:organization & administration; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom
keywords: early detection of cancer; general practice; patient education, primary health care