title: Women's interpretation of and responses to potential gynaecological cancer symptoms: a qualitative interview study.
abstract: OBJECTIVE
  To explore women's experiences of symptoms potentially indicative of gynaecological cancer in a community-based sample without imposing a cancer perspective.
  
  
  METHODS
  A qualitative interview study with thematic analysis of transcripts.
  
  
  METHODS
  26 women aged ≥30 years, who had experienced a symptom that might indicate gynaecological cancer in the past 3 months, were recruited using a screening questionnaire distributed online and in community settings.
  
  
  METHODS
  London, UK.
  
  
  RESULTS
  Women attributed gynaecological symptoms to existing illnesses/conditions or considered themselves to be predisposed to them, either through their 'genes' or previous personal experience. Normalising symptoms by attributing them to demographic characteristics (eg, age, sex) was common, as was considering them a side effect of hormonal contraception. When women raised cancer as a possible cause, they often dismissed it as unlikely. Responses to symptoms included self-management (eg, self-medicating, making lifestyle changes), adopting a 'lay system of care', or consulting a healthcare professional. Triggers to help-seeking included persistent, painful or debilitating symptoms, concern about symptom seriousness, and feeling that help-seeking was legitimised. Barriers to help-seeking included lack of concern, vague symptoms, unusual symptom location, competing time demands, previous negative experiences with the healthcare system, and not wanting to be perceived as a time-waster.
  
  
  CONCLUSIONS
  Attributions of symptoms potentially indicative of a gynaecological cancer were varied, but most often involved women fitting symptoms into their expectations of what was 'normal'. Normalising acted as a barrier to seeking help from a healthcare professional, alongside competing time demands and negative attitudes towards help-seeking. These barriers may lead to later diagnosis and poorer cancer survival. Our findings could be used to inform the development of interventions to encourage appropriate help-seeking.
authors.affiliation: Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London (UCL), London, UK.
authors.forename: E L
authors.initials: EL
authors.lastname: Low
authors.affiliation: School of Health Sciences, University of Surrey, Guildford, Surrey, UK.
authors.forename: K L
authors.initials: KL
authors.lastname: Whitaker
authors.affiliation: Centre for Health Services Research, City University, London, UK.
authors.forename: A E
authors.initials: AE
authors.lastname: Simon
authors.affiliation: Centre for Health Services Research, City University, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Sekhon
authors.affiliation: Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London (UCL), London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Waller
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008131:London; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D012651:Self Medication; D063189:Symptom Assessment / Q000523:psychology*
keywords: GYNAECOLOGY; PREVENTIVE MEDICINE; PRIMARY CARE; PUBLIC HEALTH; QUALITATIVE RESEARCH