Patient-related diagnostic delay has been established as an analytical category in cancer research. This category has come under critique because it postulates linear cause-and-effect explanations of delayed care-seeking. These explanations are based on a one-dimensional idea of causality that neglects the processual character and the contextual situatedness of bodily experiences and care-seeking decisions. Using a notion of causality that is both process-oriented and context-sensitive, this article aims to understand ovarian cancer patients’ stories on delayed healthcare seeking. It uses data from a qualitative interview study that investigated ovarian cancer patients’ illness and healthcare-seeking experiences. We suggest that the interviewees’ retrospective perspective generated a multilayered notion of diagnostic delay that differs from the definition of patient-related delay commonly used in the literature. Our analysis shows how interviewees negotiate current social discourses on health and (social) responsibility, and thereby situate themselves and their healthcare seeking within a broader socio-economic and political context.
Susanne Brandner works as a physician at the Department of Gynaecology, Obstetrics and Oncology, Hospital Dueren. She holds a doctorate in Medicine and a Master of Social Anthropology. Her main re-search interests focus on the interface of gynaecologic oncology and medical anthropology. E-mail: susanne.brandner@googlemail.com
Wiebke Stritter works as a psychologist and research associate at the Department of Paediatrics, Division of Oncology and Haematology and is a PhD candidate at the Institute of Public Health both at the Charité Universitätsmedizin Berlin. Her main re-search interests are in health service research and integrative medicine primarily in paediatric oncology. E-mail: wiebke.stritter@charite.de
Jacqueline Müller-Nordhorn is a physician and a professor of Public Health at the Institute of Public Health, Charité – Universitätsmedizin Berlin. In 2015 she became ASPHER (Association of Schools of Public Health in the European Region) president. Her research focuses on health services research, particularly cardiovascular diseases and cancer, and evidence-based prevention. E-mail: jacqueline.mueller-nordhorn@charite.de
Jalid Sehouli is a gynaecological oncologist and the director of the Department of Gynaecology at the Charité Universitätsmedizin Berlin. He is the head of the European Competence Center for Ovarian Cancer and a member of the executive boards of several national and international medical societies in gynaecological oncology. E-mail: jalid.sehouli@charite.de
Christina Fotopoulou is a consultant gynaecological oncologist at Queen Charlotte’s & Chelsea Hospital, London, UK. She was the leading consultant and vice director of the Clinic for Gynaecology at the Charité in Berlin. She has also been the principal coordinator of the European Competence Centre for Ovarian Cancer. E-mail: chfotopoulou@gmail.com
Christine Holmberg holds a doctorate in Anthropology and a Master of Public Health in Epidemiology. She is senior researcher at the Institute of Public Health, Charité- Universitätsmedizin Berlin, where she established and heads a research group dedicated to understanding and improving health decision-making, illness experience and knowledge circulation. E-mail: christine.holmberg@charite.de