Anticipated time to seek medical advice for possible ovarian cancer symptoms and perceived barriers to early presentation among Palestinian women: a national cross-sectional study
Mohamedraed Elshami,
Sondos Al-Madhoun,
Mohammed Alser,
Ibrahim Al-Slaibi,
Areej Yaseen,
Aya Tuffaha,
Hadeel Jabr,
Sara Ubaiat,
Salma Khader,
Reem Khraishi,
Inas Jaber,
Zeina Abu Arafeh,
Aya Alqattaa,
Asmaa Abd El Hadi,
Ola Barhoush,
Maysun Hijazy,
Tamara Eleyan,
Amany Alser,
Amal Abu Hziema,
Amany Shatat,
Falasteen Almakhtoob,
Balqees Mohamad,
Walaa Farhat,
Yasmeen Abuamra,
Hanaa Mousa,
Reem Adawi,
Alaa Musallam,
Shurouq I. Albarqi,
Nasser Abu-El-Noor,
Bettina Bottcher
Affiliations
Mohamedraed Elshami
Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center
Sondos Al-Madhoun
Al-Shifa Hospital
Mohammed Alser
United Nations Relief and Works Agency for Palestine Refugees (UNRWA)
Ibrahim Al-Slaibi
Almakassed Hospital
Areej Yaseen
Faculty of Medicine, Al-Quds University
Aya Tuffaha
Al-Watani Hospital
Hadeel Jabr
Ministry of Health
Sara Ubaiat
Faculty of Medicine, Al-Quds University
Salma Khader
United Nations Relief and Works Agency for Palestine Refugees (UNRWA)
Reem Khraishi
Faculty of Medicine, An-Najah National University
Inas Jaber
Faculty of Medicine, Al-Quds University
Zeina Abu Arafeh
Faculty of Medicine, Al-Quds University
Aya Alqattaa
Faculty of Medicine, Islamic University of Gaza
Asmaa Abd El Hadi
Faculty of Medicine, Islamic University of Gaza
Ola Barhoush
United Nations Relief and Works Agency for Palestine Refugees (UNRWA)
Maysun Hijazy
Faculty of Medicine, Islamic University of Gaza
Tamara Eleyan
United Nations Relief and Works Agency for Palestine Refugees (UNRWA)
Amany Alser
Faculty of Medicine, Islamic University of Gaza
Amal Abu Hziema
Faculty of Medicine, Islamic University of Gaza
Amany Shatat
Faculty of Medicine, Islamic University of Gaza
Falasteen Almakhtoob
Faculty of Medicine, Palestine Polytechnic University
Balqees Mohamad
Doctors Without Borders (Medecins Sans Frontieres)
Abstract Background Several factors contribute to delayed presentation with ovarian cancer (OC) symptoms including poor symptom awareness and barriers to seeking help. This study explored the anticipated time to seek medical advice for possible OC symptoms and its association with OC symptom awareness. In addition, it examined perceived barriers that may delay help-seeking among Palestinian women. Methods A cross-sectional study was conducted among adult women (≥ 18 years) recruited from hospitals, primary healthcare centers, and public spaces in 11 Palestinian governorates. A modified version of the OC awareness measure was used to collect data in face-to-face interviews. The questionnaire comprised three sections: sociodemographic details, awareness of 11 OC symptoms and time to seek medical advice, and barriers to early presentation. Results Of 6095 participants approached, 5618 completed the OCAM (response rate = 92.1%). The proportion of participants who would immediately seek medical advice for a possible OC symptom varied based on the symptom’s nature. For OC symptoms with pain, the proportion that reported immediate seeking of medical advice ranged from 7.9% for ‘persistent low back pain’ to 13.6% for ‘persistent pain in the pelvis’. For non-specific potential OC symptoms, the proportion that reported immediate seeking of medical advice ranged from 2.3% for ‘feeling full persistently’ to 15.8% for ‘increased abdominal size on most days’. Good OC symptom awareness was associated with higher likelihood of seeking medical advice within a week from recognizing 10 out of 11 OC symptoms. Emotional barriers were the most common barriers with ‘feeling scared’ as the most reported barrier (n = 1512, 52.4%). Displaying good OC symptom awareness was associated with a lower likelihood of reporting ≥ 4 emotional barriers (OR = 0.61, 95% CI: 0.38–0.98). Conclusion Participants with good OC symptom awareness were more likely to seek medical advice earlier and to display fewer emotional barriers. Establishing educational interventions to raise OC awareness may help in promoting earlier help-seeking and, thus, facilitate earlier diagnosis and improved prognosis.
