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Patients' help-seeking experiences and delay in cancer presentation: a qualitative synthesis

Smith, Lucy K., Pope, Catherine and Botha, Johannes L. (2005) Patients' help-seeking experiences and delay in cancer presentation: a qualitative synthesis The Lancet, 366, (9488), pp. 825-831. (doi:10.1016/S0140-6736(05)67030-4).

Record type: Article


Background: The reduction of delay in cancer diagnosis has been targeted as a way to improve survival. We undertook a qualitative synthesis of international research evidence to provide insight into patients' experiences of recognising symptoms of cancer and seeking help.
Methods: We searched international publications (1985–2004) for delay in cancer diagnosis to identify the relevant qualitative research, and used meta-ethnography to identify the common themes across the studies. Our synthesis interpreted individual studies by identification of second-order constructs (interpretations offered by the original researchers) and third-order constructs (development of new interpretations beyond those offered in individual studies).
Findings: We identified 32 papers (>775 patients and carers) reporting help-seeking experiences for at least 20 different types of cancer. The analysis showed strong similarities in patients with different cancer types. Key concepts were recognition and interpretation of symptoms, and fear of consultation. Fear manifested as a fear of embarrassment (the feeling that symptoms were trivial or that symptoms affected a sensitive body area), or a fear of cancer (pain, suffering, and death), or both. Such analyses allowed exploration of third-order constructs. The patient's gender and the sanctioning of help-seeking were important factors in prompt consultation.
Interpretation: Strategies to understand and reduce patients' delay in cancer presentation can help symptom recognition but need to address patients' anxieties. The effect of the patient's sex in help-seeking also needs to be recognised, as does the important role of friends, family, and health-care professionals in the sanctioning of consultation. This meta-ethnography provides an international overview through the systematic synthesis of a diverse group of small-scale qualitative studies.

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More information

Published date: 3 September 2005
Keywords: delay in cancer presentation, patients' experiences, help-seeking experiences, qualitative synthesis
Organisations: Nursing & Midwifery


Local EPrints ID: 19212
ISSN: 0140-6736
PURE UUID: b400855a-c8ac-45df-9620-14a121c98bf7
ORCID for Catherine Pope: ORCID iD

Catalogue record

Date deposited: 31 Jan 2006
Last modified: 17 Jul 2017 16:33

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Author: Lucy K. Smith
Author: Catherine Pope ORCID iD
Author: Johannes L. Botha

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