Implications of delayed diagnosis in colorectal cancer.
BACKGROUND
Delayed diagnosis of colorectal cancer (CRC) continues to produce anxiety and is associated with the assumption that disease stage and survival will be worse. The aims of the present study were to assess the prevalence and reasons for delay in the diagnosis of CRC, and the effects of delay, gender, age and tumour site on the stage of disease.


METHODS
A retrospective study of 100 patients presenting with CRC during a 1-year period was performed. Delay was defined to have occurred if more than a 3-month period had lapsed from the time when initial symptoms were clearly established to the time of operation. Data were collected on principal presenting symptoms, time to first presentation to a doctor, time to diagnosis and treatment, reasons for delay, diagnostic procedures, tumour site, operation, and Australian clinicopathological (ACP) stage of the tumour.


RESULTS
Thirty-four patients had a delay in diagnosis of their cancer. In 18 patients (53%) delay was attributable to patient reasons; in 13 patients (38%) delay was attributable to doctor-related delay and in three patients (9%) it was attributable to both. Male patients were more likely to have patient-related delay (31% for male patients vs 10% for female patients; P = 0.011). Patients with delay were less likely to have a stage A tumour (6% for delay group vs 21% for non-delay group; P = 0.04). Male patients were less likely to have a stage A tumour than female patients (8% for male patients vs 25% for female patients; P = 0.018), but the effect of delay on stage disappeared when gender and tumour site were controlled in a logistic regression model.


CONCLUSIONS
The present study suggests some areas where improvements may be made concerning early diagnosis and treatment of patients with CRC.
Young
C J
CJ
Colorectal Unit, Royal Adelaide Hospital, South Australia, Australia.
Sweeney
J L
JL
Hunter
A
A
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006266:Health Education; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013997:Time Factors