Experiences of women with advanced cervical cancer before starting the treatment: Systematic review of qualitative studies

Background. Advanced stage and high mortality are characteristics of cervical cancer in developing countries. The comprehension of the diagnosis itinerary is one of the main strategies to control the disease impact. Objectives. We aimed to identify reasons for the delay in the diagnosis of symptomatic cervical cancer according to the patient’s perspectives reported in qualitative studies. Search Strategy. We searched in four databases (PubMed, Embase, CINAHL, and Web of Science) until April 2020. In August 2021, we screened the papers’ references for more articles. Selection Criteria. We included qualitative studies of women with advanced cervical cancer that explored their experiences before treatment. We excluded unoriginal studies, non-qualitative and duplicated studies. Language criteria or time limits were not applied. Data Collection and Analysis. We selected 39 articles for a full reading. We included fifteen and excluded twenty-four papers. Furthermore, we choose the Consolidated Criteria for Reporting Qualitative Research (COREQ) for quality assessment. BSR codified the papers included. She chose The Model of Pathways to Treatment to guide the codifying process. Main Results. The studies reported between 11-27 of the 32 COREQ-checklist items. Four main themes emerged from the synthesis: 1) Health seeking motivators; 2) Obstacles to seek medical care; 3) Diagnosis delay; 4) Coping with the disease. These themes were derived from a combination of patient personal knowledge and beliefs, social relationships, socioeconomic status, and characteristics of the healthcare system. Conclusions. Individual behavior, social factors, and health care organization contribute to the delay in diagnosing advanced cervical cancer.