Delays in diagnosis of young women with symptomatic cervical cancer in England: an interview-based study

Lim, Anita W. W. and Ramirez, Amanda J. and Hamilton, William and Sasieni, Peter and Patnick, Julietta and Forbes, Lindsay J.L. (2014) Delays in diagnosis of young women with symptomatic cervical cancer in England: an interview-based study. British Journal of General Practice, 64 . e602-e610. ISSN 0960-1643. E-ISSN 1478-5242. (doi:https://doi.org/10.3399/bjgp14X681757) (Full text available)

Abstract

Background Diagnosis may be delayed in young females with cervical cancer because of a failure to recognise symptoms. Aim To examine the extent and determinants of delays in diagnosis of young females with symptomatic cervical cancer. Design and setting A national descriptive study of time from symptoms to diagnosis of cervical cancer and risk factors for delay in diagnosis at all hospitals diagnosing cervical cancer in England. Method One-hundred and twenty-eight patients <30 years with a recent diagnosis of cervical cancer were interviewed. Patient delay was defined as ≥3 months from symptom onset to first presentation and provider delay as ≥ 3 months from first presentation to diagnosis. Results Forty (31%) patients had presented symptomatically: 11 (28%) delayed presentation. Patient delay was more common in patients <25 than patients aged 25–29 (40% versus 15%, P = 0.16). Vaginal discharge was more common among patients who delayed presentation than those who did not; many reported not recognising this as a possible cancer symptom. Provider delay was reported by 24/40 (60%); in some no report was found in primary care records of a visual inspection of the cervix and some did not re-attend after the first presentation for several months. Gynaecological symptoms were common (84%) among patients who presented via screening. Conclusions Young females with cervical cancer frequently delay presentation, and not recognising symptoms as serious may increase the risk of delay. Delay in diagnosis after first presentation is also common. There is some evidence that UK guidelines for managing young females with abnormal bleeding are not being followed.

Item Type: Article
Uncontrolled keywords: cervical cancer; delays; early diagnosis; symptoms; young females
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 25 Jan 2016 11:15 UTC
Last Modified: 01 Dec 2016 14:10 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/53844 (The current URI for this page, for reference purposes)
Forbes, Lindsay J.L.: https://orcid.org/0000-0002-4654-9520
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