BackgroundPost-treatment follow-up visits for gynecological cancer survivors should provide opportunities for management of adverse physical/psychological effects of therapy and early recurrence detection. However, the adequacy of such visits in Japan is poorly documented. We qualitatively explored care-seeking experiences of Japanese gynecological cancer survivors and deduced factors influencing care-seeking behaviors and treatment access.MethodsWe conducted 4 semi-structured focus groups comprising altogether 28 Japanese gynecological cancer survivors to collect a variety of participants’ post-treatment care-seeking behaviors through active interaction with participants. Factors influencing access to treatment for adverse effects were analyzed qualitatively.ResultsSurvivors sought care through specialty clinic visits when regular post-treatment gynecological follow-ups were inadequate or when symptoms seemed to be non-treatment related. Information provided by hospital staff during initial treatment influenced patients’ understanding and response to adverse effects. Lack of knowledge and inaccurate symptom interpretation delayed help-seeking, exacerbating symptoms. Gynecologists’ attitudes during follow-ups frequently led survivors to cope with symptoms on their own. Information from mass media, Internet, and support groups helped patients understand symptoms and facilitated care seeking.ConclusionsPost-treatment adverse effects are often untreated during follow-up visits. Awareness of possible post-treatment adverse effects is important for gynecological cancer survivors in order to obtain appropriate care if the need arises. Consultation during the follow-up visit is essential for continuity in care.

Background The rate of young Japanese women attending Cervical Cancer screenings is still low. There is a lack of studies that discussed awareness, preference, and anxiety of women to HPV self-sampling. The aim was to clarify the awareness of young women who want and do not want HPV self-sampling toward improvement the rate of attending Cervical Cancer screenings. Methods We carried out the observation study by self-administered questionnaires about the awareness of HPV self-sampling with the trial in a city, in Hokkaido, Japan. The subjects were selected at random to 25-29 years old women (837 persons) residing in a city. We compared their awareness between want and do not want self-sampling. For data analysis, statistical analysis software SPSS for Windows Ver.21 was used setting the significance level at below 5%. Results Young women in this study who firstly responded wanting practice of self-sampling were 9.8%, and not wanting in were 90.2%. The reasons of young women that want self-sampling were "Free selfsampling supported from the city", "I can do it in my own time", and "I have experience of sexual intercourse". In contrast, the reasons of do not want self-sampling were "I have no symptom", and "I am anxious about doing the test by myself". The awareness of HPV self-sampling was low with all subjects, and they have few the general knowledge of Cervical Cancer. Conclusion There is a possibility to increase the number of young women who want self-sampling by using an HPV self-sampling trial of the opt-in method that also considers the emotions of the women. Young Japanese women who do not want self-sampling, tend to have a fear and anxiety toward selfsampling, in contrast, many of the women who conducted self-sampling prefer it. This study suggests the need of new practical education for self-sampling, including HPV infection, and Cervical Cancer prevention performed by clinicians, nurses and midwives.

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