Pacific women's pre-diagnostic experiences of endometrial cancer across the Auckland region: a qualitative study using talanoa.

INTRODUCTION: Pacific women are disproportionally affected by endometrial cancer in Aotearoa New Zealand. Early detection of endometrial cancer is critical to enable timely treatment, provide treatment choices and improve patient outcomes. AIM: This study sought to understand the pre-diagnostic experiences of Pacific women treated for endometrial cancer in the Auckland region. METHODS: We used a talanoa approach (Pacific methodology) with 13 Pacific women aged ≥18 years who had undergone treatment for endometrial cancer in the three Health New Zealand | Te Whatu Ora districts in the Auckland region. One-on-one semi-structured talanoa were undertaken to explore their pre-diagnostic experiences. Thematic analysis of the data according to Braun and Clarke's six-step approach was undertaken. RESULTS: Pacific women had limited endometrial cancer-related awareness prior to their diagnosis. The majority of premenopausal women experienced unnecessary delays in diagnostic assessment and referral to gynaecology services (and consequently, increased morbidity and poorer prognosis) despite multiple medical appointments and failed medical management. Abnormal uterine bleeding had negative consequences regarding psychological wellbeing and quality of life for premenopausal participants. DISCUSSION: Improved endometrial cancer-related awareness and knowledge is urgently required among Pacific women. Greater awareness of abnormal uterine bleeding health pathways among healthcare professionals would facilitate timely referral to diagnostic testing and gynaecology services. Equitable healthcare access for Pacific women with endometrial cancer symptoms is critical for timely diagnosis and to reduce negative consequences for endometrial cancer-related morbidity, prognosis and quality of life.