title: Why so late?!--delay in treatment of colorectal cancer is socially determined.
abstract: OBJECTIVE
  The interval between symptom onset and therapy in patients with colorectal cancer was studied.
  
  
  METHODS
  One hundred twenty three patients with colorectal cancer were included. Demography data, symptoms, consultations, and tumour stage were obtained by standardized questionnaires. Risk factors for delayed treatment were analysed.
  
  
  RESULTS
  Eighty six patients suffered from colonic cancer. The total time between the first symptoms and therapy ranged from 13 to 442 days (mean, 148). Delay of surgical therapy was responsible for significantly higher tumour grades. Delayed start of therapy was found to be correlated to the type of cancer, socioeconomic status, marital status, and quality of first consultation (univariate analysis). On multivariate analyses, type of cancer, marital and socioeconomic status remained significantly associated with delayed treatment (all p values ≤ 0.001, r(2) = 0.50).
  
  
  CONCLUSIONS
  The delay in treatment of colorectal cancer depends on socioeconomic status and family background. Achieving equity in colorectal cancer detection may require consideration of high-risk subgroups.
authors.affiliation: Helios St. Elisabeth Klinik Oberhausen, Department of Surgery II, University of Witten/Herdecke, Oberhausen, Germany. mike-ralf.langenbach@helios-kliniken.de
authors.forename: Mike Ralf
authors.initials: MR
authors.lastname: Langenbach
authors.forename: Stefan
authors.initials: S
authors.lastname: Sauerland
authors.forename: Karl-Wilhelm
authors.initials: KW
authors.lastname: Kröbel
authors.forename: Hubert
authors.initials: H
authors.lastname: Zirngibl
mesh_terms: D000368:Aged; D003082:Colectomy; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D057210:Delayed Diagnosis; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D012017:Referral and Consultation; D012959:Socioeconomic Factors; D047368:Tumor Burden