Ovarian Cancer in Essex: Understanding Symptom Recognition, Help-Seeking and Barriers to Action

NHS Essex ran a survey to explore awareness of ovarian cancer and its symptoms, intended help-seeking behaviour, and barriers to seeking medical advice. The survey was conducted between 1 July and 5 August 2026 and received 1,500 responses from across Essex.

1. Executive summary

Background

Ovarian cancer is the sixth most common cancer in women in the UK,¹ and earlier diagnosis is associated with improved outcomes.

To support the development of future ovarian cancer earlier diagnosis activity across Essex, a public survey was undertaken using the Essex Virtual Views platform. The survey explored awareness of ovarian cancer, recognition of symptoms, intended help-seeking behaviour and barriers to seeking medical advice.

The survey was conducted between 1 July and 5 August 2026 and received 1,500 responses from across Essex.

Key findings

Awareness of ovarian cancer is high, but recognition of symptoms is uneven

Awareness of ovarian cancer was extremely high (98.9%)

Recognition was highest for pelvic or abdominal pain (87.9%) and bloating (80.3%), but fewer than half recognised appetite-related or urinary symptoms.

Concern about symptoms is substantially higher than intended action

While 69.7% said persistent symptoms would cause concern, only 42.4% said they would make a GP appointment. Many would seek information or monitor symptoms before acting.

Practical and cognitive barriers were more commonly reported than emotional barriers

Difficulty obtaining an appointment was the most reported barrier to seeking help.

By comparison, embarrassment and difficulty discussing symptoms were reported relatively infrequently.

Information seeking commonly preceded intended help-seeking

Many respondents indicated that they would search for information before seeking professional advice, suggesting that decisions about seeking help are often preceded by a period of information gathering, reassurance-seeking and symptom appraisal.

Social media was the most common channel through which respondents had recently seen NHS ovarian cancer information, while GPs and NHS websites were the most commonly selected sources when actively seeking advice. This suggests different channels support different stages of the help-seeking journey.

Some population groups were more likely to delay seeking help

Younger and middle-aged respondents were often aware of key ovarian cancer symptoms but were more likely to delay seeking advice, search for information or dismiss symptoms as not serious enough to require medical attention.

Respondents in Harlow, Colchester and Tendring were among the least likely to report that they would contact a GP first and among the most likely to indicate that symptoms may not be serious enough to require medical advice. These areas contain five of the ten OOH Cancer Programme priority PCNs.

Conclusion

Awareness of ovarian cancer was high across the survey population, and recognition of some key symptoms, particularly bloating and pelvic or abdominal pain, was also strong. However, high levels of awareness and symptom recognition did not consistently translate into action.

Whilst many respondents indicated that persistent symptoms would cause concern, fewer said they would make an appointment with their GP and many reported that they would first seek information or monitor symptoms.

Future activity is therefore likely to have greatest impact where it supports people to move from concern to action, reinforces when persistent symptoms require medical advice, and addresses the different barriers experienced across priority geographies.

2. Introduction

Ovarian cancer symptoms can be associated with more common or less serious conditions, contributing to delays in help-seeking and diagnosis.

Improving symptom awareness and encouraging timely help-seeking are therefore important for earlier diagnosis and reducing inequalities in outcomes.

The Out of Hospital (OOH) Cancer Programme supports these aims across Essex, with enhanced activity focused on ten priority Primary Care Networks (PCNs) during 2026/27.

Purpose of the survey and this report

The survey was undertaken to understand:

• awareness of ovarian cancer
• symptom recognition
• intended responses to persistent symptoms
• barriers to seeking medical advice
• sources of information and support
• variation by population group and geography.

This report presents the findings through a COM-B behavioural lens and identifies implications for future communication, engagement and early diagnosis activity across Essex.

3. Methodology

Survey design

A structured online survey explored awareness of ovarian cancer, symptom recognition, interpretation of persistent symptoms, intended help-seeking behaviour, barriers to action, information sources and demographic characteristics.

The questionnaire included single-response, multiple-response and open-text questions.

Fieldwork

The survey was conducted between 1 July 2026 and 5 August 2026 using the Essex Virtual Views platform. A total of 1,500 responses were received.

Analysis

Responses were analysed overall and by demographic and geographic characteristics, including age, local authority area and long-term health conditions.

Analytical approach

Findings were interpreted using the COM-B behavioural framework, which considers how capability, motivation and opportunity influence behaviour.

The framework has been used to organise findings relating to:

• knowledge and awareness of symptoms
• decisions about whether symptoms require action
• factors that may support or hinder seeking medical advice.

Limitations

As with all surveys, findings are subject to limitations.

Findings reflect self-reported awareness, attitudes and intended behaviours, which may differ from actual behaviour.

The survey was not designed to provide representative findings at Primary Care Network (PCN) level, and response volumes varied across local authority areas. Geographic findings should therefore be interpreted as indicative rather than representative of local population attitudes.

Most respondents were recorded within a single ethnic group category, and numbers within minority ethnic groups were too small for robust subgroup analysis.

4. Survey context and interpretation

Survey sample

A total of 1,500 respondents completed the survey. Responses were received from all Essex local authority areas, although participation varied geographically.

The largest numbers came from Chelmsford, Southend, Braintree and Colchester, while Epping Forest and Uttlesford had the fewest respondents.

The largest respondent groups were aged 50-64 and 65-74 years, with lower participation among younger and older age groups.

Many respondents reported one or more long-term physical or mental health conditions. However, variation in intended help-seeking was more pronounced by age and geography and therefore form the focus of subsequent analysis.

Using and interpreting the findings

This survey forms one part of the evidence base supporting ovarian cancer early diagnosis activity across Essex. Findings should be considered alongside existing cancer, inequalities and population health intelligence.

Together, these sources provide insight into how people interpret symptoms, decide whether medical advice is needed and experience barriers to help-seeking.

5. Symptom recognition and awareness

COM-B Domain: Capability

This section examines awareness of ovarian cancer and recognition of symptoms associated with the disease.

Awareness of ovarian cancer was extremely high

Awareness of ovarian cancer was extremely high, with 98.9% of respondents reporting that they had heard of the disease.

Awareness of NHS priority symptoms Is uneven

The NHS identifies four main symptoms of ovarian cancer²:

• A swollen tummy or bloating
• Pelvic or abdominal pain
• Loss of appetite or feeling full quickly
• Needing to pee more often or more urgently.

Recognition was particularly high for:

By comparison, fewer than half of respondents recognised:

Recognition was also relatively high for unusual vaginal bleeding (77.1%) and unexplained weight loss (71.1%).

Awareness alone does not explain differences in intended help-seeking

Younger and middle-aged respondents were often as likely, or in some cases more likely, to recognise appetite-related and urinary symptoms than older respondents. However, these same groups were also more likely to delay seeking advice, seek information first or indicate that symptoms might not be serious enough to seek medical attention.

Although ovarian cancer incidence increases with age, the findings suggest that younger and middle-aged respondents may be more likely to seek reassurance, monitor symptoms or dismiss symptoms as not serious, despite often demonstrating comparable awareness of key symptoms.

Overall assessment

Awareness of ovarian cancer was high, and recognition was strongest for bloating and pelvic or abdominal pain. Appetite-related and urinary symptoms were less well recognised, suggesting awareness is concentrated around a narrower symptom profile than that highlighted in NHS guidance. Analysis by age indicates that differences in intended help-seeking are not explained by awareness alone, and that symptom interpretation may also influence behaviour.

6. Interpreting symptoms and deciding to act

COM-B Domain: Motivation

This section explores how respondents would interpret and respond to persistent symptoms.

Concern about persistent symptoms was high, but intention to seek help was lower

Almost seven in ten respondents (69.7%) indicated that persistent symptoms would cause concern. This included 42.4% who said they would be concerned and make an appointment with their GP, while 27.3% said they would be concerned but wait to see whether symptoms improved.

Only half would contact a GP first

Respondents were asked what they would be most likely to do first if they experienced persistent symptoms.

*Other responses included contacting NHS 111, speaking to a pharmacist, speaking to family or friends, using the NHS App, doing nothing or being unsure what to do.

While speaking to a GP was the most common response, many respondents said they would first seek information or wait to see whether symptoms improved. This suggests that decisions about seeking medical advice are often preceded by a period of information gathering or symptom monitoring.

Ovarian cancer may feel like a low personal risk

Only 6.8% of respondents considered themselves very likely to develop ovarian cancer during their lifetime. By comparison, 35.0% selected neither likely nor unlikely and 20.9% were unsure.

These findings suggest that ovarian cancer may feel relatively unlikely or personally irrelevant for many respondents. This may contribute to respondents monitoring symptoms, seeking reassurance or considering alternative explanations before seeking medical advice.

According to Cancer Research UK, the estimated lifetime risk of being diagnosed with ovarian cancer is around 1 in 56 (2%) for females born in 1961 in the UK.³

Younger and middle-aged respondents were more likely to delay seeking advice

Analysis by age suggests important differences in how symptoms are interpreted and acted upon.

Respondents aged 25-49 were generally more likely to:

• search for information before seeking advice
• adopt a wait-and-see approach
• indicate that symptoms may not be serious enough to seek medical attention.

By contrast, respondents aged 50 and over were generally more likely to report that they would contact a GP first.

Importantly, younger and middle-aged respondents did not consistently demonstrate lower awareness of key ovarian cancer symptoms, suggesting that interpretation of symptoms may be a more important influence on intended help-seeking than awareness alone.

Overall assessment

Persistent symptoms were widely recognised as a cause for concern. However, many respondents reported they would seek information, monitor symptoms or wait to see whether symptoms improved before seeking medical advice. The findings indicate a gap between concern about persistent symptoms and intention to seek help.

7. Barriers to seeking help

COM-B Domain: Opportunity

This section explores the practical, emotional and cognitive barriers that may prevent respondents from seeking medical advice if symptoms persisted or worsened.

Practical barriers were most common

Difficulty getting an appointment (50.6%) was the most commonly reported barrier to seeking help.

People continue to assess symptoms before seeking help

As highlighted in Section 6:

• 69.7% said persistent symptoms would concern them.
• 42.4% said they would make an appointment with their GP.
• 27.3% said they would be concerned but wait to see whether symptoms improved.

Similarly:

• 49.3% would contact a GP first.
• 24.7% would search online first.
• 12.7% would wait and see before seeking advice.

These findings suggest that delays may arise not only from practical barriers, but also from uncertainty about whether symptoms warrant medical advice.

Emotional barriers were less prominent

Concerns about obtaining an appointment and uncertainty about symptom significance were reported more often than embarrassment or difficulty discussing symptoms.

 Only:

• 6.3% selected embarrassment.
• 4.2% selected difficulty talking about symptoms.

Barriers varied across Essex

Analysis by geography suggests that barriers to help-seeking are not evenly distributed across Essex.

Respondents in Harlow, Colchester and Tendring were among the most likely to indicate that symptoms may not be serious enough to need medical advice. These areas were also among the least likely to report that they would contact a GP first if symptoms persisted.

Respondents in Harlow and Colchester were also among the most likely to report concerns about wasting the GP’s time, suggesting that some people may question whether seeking help is justified.

By contrast, respondents in Basildon demonstrated relatively strong awareness of symptoms and a greater willingness to seek help but were among those most likely to report difficulties obtaining an appointment.

Overall assessment

Practical and cognitive barriers were more commonly reported than emotional barriers.

Difficulty obtaining an appointment was the most frequently reported barrier, alongside uncertainty about whether symptoms warranted medical advice.

Concerns about symptom significance appeared particularly important in Harlow, Colchester and Tendring, while access to appointments was more prominent in Basildon.

8. Information sources and decision-making

COM-B Domain: Opportunity

This section explores where respondents seek information, the sources they trust and their exposure to ovarian cancer awareness activity.

Trusted information sources

Respondents were asked where they would be most likely to look for information if they experienced symptoms that concerned them.

Other sources accounted for 14.8% of responses and included the NHS App, NHS 111, pharmacists, family or friends, AI tools and other options.

Respondents were most likely to identify GPs and NHS websites as their preferred sources of health information. Search engines were also commonly selected, suggesting they often serve as a gateway to information when people are seeking to understand symptoms and decide whether further advice is needed.

Recent exposure to ovarian cancer awareness activity was low

Respondents were asked whether they had recently seen or heard information about ovarian cancer symptoms.

Only 15.6% reported seeing NHS information about ovarian cancer symptoms.

This suggests that the high levels of awareness identified elsewhere in the survey are unlikely to be explained solely by recent exposure to NHS awareness activity.

Information gathering often precedes help-seeking

Earlier findings showed that only 49.3% of respondents would contact a GP first if they experienced persistent symptoms, whilst 24.7% would search online and 12.7% would initially wait to see whether symptoms improved. These findings suggest that many respondents gather information before deciding whether medical advice is needed.

When actively seeking advice about symptoms, respondents most commonly identified GPs (32.2%) and NHS websites (31.8%) as their first sources of information. By contrast, social media was rarely selected as a first source of information (0.3%), despite being a commonly reported channel through which respondents had recently encountered NHS ovarian cancer information (31.9%). This indicates that different channels may play different roles in the journey from awareness to help-seeking.

Overall assessment

Information gathering appears to be an important part of the pathway to help-seeking. Respondents were most likely to identify GPs and NHS websites as their preferred sources of health information, while many indicated they would seek information before contacting a healthcare professional. Recent exposure to NHS ovarian cancer awareness activity was relatively low, suggesting opportunities to increase the visibility of trusted information during the period when people are deciding whether symptoms require medical advice.

9. Audience and geographic behavioural profiles

Analysis by age and geography identified important differences in awareness, intended behaviours and barriers to help-seeking.

Variation by age

Respondents aged 50 and over were more likely to report contacting a GP first

Analysis by age suggests that respondents aged 50 and over were generally more likely to say they would contact a GP first if symptoms persisted, whilst younger and middle-aged respondents were more likely to search for information or wait to see whether symptoms improved.

While ovarian cancer incidence increases with age, the findings highlight the importance of helping younger and middle-aged women recognise when persistent symptoms warrant medical advice.

Younger respondents were more likely to view symptoms as not serious

Respondents aged 25 to 44 were approximately twice as likely as those aged 65 and over to indicate that symptoms may not be serious enough to need medical advice.

Importantly, younger and middle-aged respondents did not consistently demonstrate lower awareness of key ovarian cancer symptoms. The findings therefore suggest that lower intentions to seek help may be more closely associated with how symptoms are interpreted than with awareness alone.

Information gathering and monitoring were particularly evident among respondents aged 45-49

Respondents aged 45-49 were among the most likely to search online first (31.7%) or adopt a wait-and-see approach (21.1%).

Variation by area

Analysis by local authority area was used to identify potential behavioural patterns relevant to OOH Cancer Programme priority PCNs. However, the survey was not designed to provide representative findings at PCN level. The findings should therefore be interpreted as indicative patterns rather than representative measures of individual PCN populations and considered alongside wider insights.

Reported intention to contact a GP varied by area

The proportion of respondents who said they would contact a GP first if symptoms persisted varied across areas.

Epping Forest recorded the highest proportion of respondents saying they would contact a GP first if symptoms persisted, followed by Uttlesford, Castle Point and Maldon.

Lower reported intention to contact a GP first in Harlow, Colchester and Tendring

Colchester, Harlow and Tendring recorded some of the lowest proportions of respondents saying they would contact a GP first if symptoms persisted.

These areas also recorded some of the highest proportions of respondents indicating that symptoms may not be serious enough to require medical advice.

Concerns about wasting the GP’s time were particularly evident in some areas

These findings suggest that lower intentions to contact a GP first in these areas may be driven by uncertainty about whether symptoms warrant medical advice. Harlow, Colchester, Southend and Tendring contain seven of the ten OOH Cancer Programme priority PCNs.

Concerns about access were particularly evident in Basildon

Concerns about obtaining an appointment were reported across several areas of Essex.

Within the context of the OOH Cancer Programme, Basildon is of particular interest because it contains two priority cancer PCNs. Although respondents reported comparatively high levels of concern about obtaining an appointment, they were also relatively likely to say they would contact a GP first if symptoms persisted.

Southend respondents reported relatively stronger intentions to seek help

In Southend, which contains two priority cancer PCNs, 52.2% of respondents said they would contact a GP first if symptoms persisted. However, 28.9% reported concerns about wasting the GP’s time, suggesting that some respondents may still question whether seeking help is justified.

Behavioural profiles of priority geographies

The survey suggests that different council areas which contain OOH cancer programme priority PCNs may require different approaches to supporting earlier help-seeking.

Summary

Analysis by age and geography identified important differences in intended help-seeking, suggesting that different populations may benefit from tailored approaches to supporting earlier presentation.

Younger respondents were more likely to seek information, monitor symptoms or view symptoms as insufficiently serious to seek medical advice.

Harlow, Colchester and Tendring appeared more affected by uncertainty about symptom significance, while concerns about access were more prominent in Basildon. Southend showed relatively strong intentions to seek help alongside continuing concerns about wasting the GP’s time. Castle Point showed relatively strong intentions to contact a GP first, with fewer identifiable barriers.

10. Behavioural diagnosis and implications for future activity

Awareness of ovarian cancer and key symptoms was high. However, many respondents reported that they would seek information, monitor symptoms or assess symptom significance before contacting a GP. This pattern was particularly evident among younger respondents and in some cancer priority geographies.

Awareness of symptoms Is uneven

Recognition was strongest for bloating and pelvic or abdominal pain, while appetite-related and urinary symptoms were less well recognised. This suggests public awareness is concentrated around a narrower symptom profile than that highlighted in NHS guidance.

Concern about symptoms does not consistently translate into action

While almost seven in ten respondents said persistent symptoms would cause concern, fewer than half said they would make a GP appointment.

Factors influencing the decision to seek help

Nearly three in ten respondents expressed concern about persistent symptoms but did not indicate that they would make an appointment with their GP. This suggests that concern alone does not consistently lead to action.

Perceptions of personal risk

Only 6.8% of respondents considered themselves very likely to develop ovarian cancer. For many respondents, ovarian cancer appeared to feel relatively unlikely or personally irrelevant, which may influence how symptoms are interpreted.

Deciding whether to seek medical advice

The findings suggest that differences in intended help-seeking are not explained by awareness alone. Respondents often recognised symptoms but remained uncertain about whether they warranted medical advice, particularly in Harlow, Colchester and Tendring.

Practical barriers remain important

Difficulty obtaining an appointment was the most commonly reported barrier. However, delays appeared to be influenced by both practical barriers and uncertainty about symptom significance.

Information gathering forms part of the pathway to help-seeking

Information gathering formed an important part of respondents’ response to persistent symptoms. Social media was an important awareness channel, while GPs and NHS websites were the most commonly selected sources when respondents actively sought advice. This suggests different channels play different roles in supporting awareness and help-seeking.

Implications for future activity

The findings suggest six priorities for supporting earlier diagnosis and timely help-seeking:

1. Broaden symptom recognition: Increase awareness of appetite-related and urinary symptoms alongside the more widely recognised symptoms of bloating and pelvic or abdominal pain.
2. Support the move from concern to action: Reinforce what people should do when symptoms persist, rather than focusing on symptom awareness alone.
3. Reduce uncertainty about symptom significance: Help people recognise when persistent symptoms need medical advice.
4. Provide trusted information at the point of decision-making: Ensure credible NHS and primary care information is visible across the channels people use when interpreting symptoms and deciding whether to seek help.
5. Address barriers to accessing care: Recognise concerns about obtaining appointments alongside cognitive and behavioural barriers.
6. Tailor activity to local behavioural patterns: Adapt communication and engagement approaches where findings suggest different barriers or levels of help-seeking intention.

Overall assessment

Awareness of ovarian cancer was high, but awareness alone did not consistently translate into intended action.

The survey identified a gap between concern about persistent symptoms and intention to seek medical advice, with many respondents reporting that they would monitor symptoms or seek information before contacting a healthcare professional.

Future activity should focus on improving recognition of less well-recognised symptoms, reducing uncertainty about when symptoms require medical advice, and supporting people to move from concern to action.

References

1. Cancer Research UK. Ovarian cancer statistics. Cancer Research UK. (Accessed 12 August 2026). Ovarian cancer statistics

2. NHS. Ovarian cancer – Symptoms. NHS. Last reviewed 17 November 2025. (Accessed 12 August 2026). Ovarian cancer – Symptoms

3. Cancer Research UK. Ovarian cancer statistics. Cancer Research UK. Last updated 13 December 2023. (Accessed 13 August 2026).Ovarian cancer statistics