Do health education interventions lead to early treatment for women with symptoms of endometrial (womb) cancer

Background
Endometrial (womb) cancer arises from the uncontrolled growth of abnormal cells in the lining of the womb. Diagnosis when the disease is still at an early stage (cancer is still within the womb, without spread into nearby tissues) is common, as most women with the disease experience abnormal vaginal bleeding and go to their doctors. However, delayed management of endometrial cancer still occurs. This is particularly a problem for women who are about to go through or are in the menopause. Providing educational information to women and healthcare providers regarding symptoms relating to endometrial cancer may raise awareness of the disease and reduce delayed treatment. We undertook this review to assess whether endometrial cancer education led to women with endometrial cancer symptoms visiting their doctors and being referred for treatment earlier than when there was no education.

The aim of the review
We undertook this review to assess whether endometrial cancer education led to women with endometrial cancer symptoms visiting their doctors and being referred for treatment earlier than when there was no educational information available.

Main findings
We planned to include randomised controlled trials (studies in which people or groups of people are allocated by chance to two or more groups, treating them differently). In the absence of randomised controlled trials, we planned to include studies where participants were not randomised but that included an assessment of the benefits of health education compared to no health education. We searched scientific databases and checked the titles and abstracts of 4880 possibly relevant articles and assessed the full text of 16 of these references. However, we found no studies that met our inclusion criteria.

Conclusions
There is currently an absence of evidence to indicate whether providing health education to healthcare providers, or individuals or both, promotes early presentation and referral for women with symptoms of endometrial cancer.

Authors' conclusions: 

There is currently an absence of evidence to indicate the effectiveness of health education interventions involving healthcare providers or individuals or both to promote early presentation and referral for women with endometrial cancer symptoms. High-quality RCTs are needed to assess whether health education interventions enhance early presentation and referral. If health education interventions can be shown to reduce treatment delays in endometrial cancer, further studies would be required to determine which interventions are most effective.

Read the full abstract...
Background: 

Diagnosis of endometrial (womb) cancer is normally made at an early stage, as most women with the disease experience abnormal vaginal bleeding, which prompts them to seek medical advice. However, delays in presentation and referral can result in delay in diagnosis and management, which can lead to unfavourable treatment outcomes. This is particularly a problem for pre- and peri-menopausal women. Providing educational information to women and healthcare providers regarding symptoms relating to endometrial cancer may raise awareness of the disease and reduce delayed treatment.

Objectives: 

To assess the effectiveness of health education interventions targeting healthcare providers, or individuals, or both, to promote early presentation and referral for women with endometrial cancer symptoms.

Search strategy: 

We searched CENTRAL, MEDLINE and Embase. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of review articles.

Selection criteria: 

We planned to include randomised controlled trials (RCTs), both individually randomised and cluster-RCTs. In the absence of RCTs we planned to include well-designed non-randomised studies (NRS) with a parallel comparison assessing the benefits of any type of health education interventions.

Data collection and analysis: 

Two review authors independently evaluated whether potentially relevant studies met the inclusion criteria for the review, but none were found.

Main results: 

A comprehensive search of the literature yielded the following results: CENTRAL (1022 references), MEDLINE (2874 references), and Embase (2820 references). After de-duplication, we screened titles and abstracts of 4880 references and excluded 4864 that did not meet the review inclusion criteria. Of the 16 references that potentially met the review inclusion, we excluded all 16 reports after reviewing the full texts. We did not identify any ongoing trials.

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