Help seeking behaviour in women diagnosed with gynaecological cancer: a systematic review

Background: Identifying what prompts or hinders women’s help seeking behaviour (HSB) is essential to ensure timely diagnosis and management of gynaecological cancers. Aim: To understand the factors that influence HSB of women diagnosed with gynaecological cancer. Design and Setting: Systematic review and narrative synthesis of studies from high-income settings. Method: Five databases were searched for studies, of any design, that presented factors related to HSB of women diagnosed with gynaecological cancer. Data from the papers were extracted and presented using narrative synthesis which was inductive and also deductive, using the COM-B behaviour change model as a framework. Results: There were 21 included studies. Inductive synthesis presented three main themes of factors related to HSB of women diagnosed with gynaecological cancer. Namely, patient factors such as knowledge of symptoms; emotional factors, including previous health care experience, embarrassment and trust; and practical factors, including time and resources. Deductive synthesis demonstrated that: capability, namely symptom knowledge; opportunity, having the required time, overcoming the cultural taboos surrounding gynaecological symptoms and motivation, believing that seeking help is beneficial, are all required to initiate HSB. Conclusion: Help seeking behaviour of women with symptoms diagnosed with gynaecological cancer, whilst a journey of defined steps, is influenced by personal and societal factors. Interventions to improve help seeking will need to address the identified factors as well as capability, opportunity and motivation.