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Minimizing delays in ovarian cancer diagnosis: an expansion of Andersen's model of total patient delay

Minimizing delays in ovarian cancer diagnosis: an expansion of Andersen's model of total patient... Background. Ovarian cancer symptoms are vague and commonly occur in benign conditions; it often presents late and is diagnosed at an advanced stage when survival rates are poor. Studies of diagnostic delay in conditions with non-specific symptoms are rare.Objectives. To study accounts of diagnostic delays in a sample of British women with ovarian cancer using Andersen's five-stage model of total patient delay as an analytic framework.Methods. Semi-structured interviews were conducted with 43 women. Maximum variation sample was recruited via GPs, clinicians, support organizations and personal contacts.Results. Most women reported pre-diagnostic symptoms and diagnostic delays. Patient delays conformed to Andersen's first four types: appraisal, illness, behavioural and scheduling delays. Treatment delays, attributable at least in part to a doctor or the health care system, were common and we have broken them down into five categories: non-investigation of symptoms, treatment for non-cancer causes, lack of follow-up, referral delays and system delays.Conclusions. Our data illuminate the reasons why some British women experience delays in obtaining an ovarian cancer diagnosis. Delays attributable to the women were often compounded by doctor or health service delays, enabling us to expand the fifth stage of Andersen's model. Diagnostic delays in general practice could be minimized by better history taking, explaining the rationale for ruling out non-cancer causes, adopting an open-door policy for patients whose symptoms persist, considering abdominal ultrasound scans and introducing educational sessions for GPs about ovarian cancer symptomatology. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Family Practice Oxford University Press

Minimizing delays in ovarian cancer diagnosis: an expansion of Andersen's model of total patient delay

Evans, Julie; Ziebland, Sue; McPherson, Ann
Family Practice , Volume 24 (1) – Dec 7, 2006
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References (24)

Publisher
Oxford University Press
Copyright
The Author 2006. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.
ISSN
0263-2136
eISSN
1460-2229
DOI
10.1093/fampra/cml063
pmid
17158183
Publisher site
See Article on Publisher Site

Abstract

Background. Ovarian cancer symptoms are vague and commonly occur in benign conditions; it often presents late and is diagnosed at an advanced stage when survival rates are poor. Studies of diagnostic delay in conditions with non-specific symptoms are rare.Objectives. To study accounts of diagnostic delays in a sample of British women with ovarian cancer using Andersen's five-stage model of total patient delay as an analytic framework.Methods. Semi-structured interviews were conducted with 43 women. Maximum variation sample was recruited via GPs, clinicians, support organizations and personal contacts.Results. Most women reported pre-diagnostic symptoms and diagnostic delays. Patient delays conformed to Andersen's first four types: appraisal, illness, behavioural and scheduling delays. Treatment delays, attributable at least in part to a doctor or the health care system, were common and we have broken them down into five categories: non-investigation of symptoms, treatment for non-cancer causes, lack of follow-up, referral delays and system delays.Conclusions. Our data illuminate the reasons why some British women experience delays in obtaining an ovarian cancer diagnosis. Delays attributable to the women were often compounded by doctor or health service delays, enabling us to expand the fifth stage of Andersen's model. Diagnostic delays in general practice could be minimized by better history taking, explaining the rationale for ruling out non-cancer causes, adopting an open-door policy for patients whose symptoms persist, considering abdominal ultrasound scans and introducing educational sessions for GPs about ovarian cancer symptomatology.

Journal

Family Practice – Oxford University Press

Published: Dec 7, 2006

Keywords: Early diagnosis ovarian neoplasms provider delay qualitative research signs and symptoms

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