title: Factors influencing late consultation among patients with rectal bleeding in University Kebangsaan Malaysia Medical Centre.
abstract: BACKGROUND
  Patients' delay in the presentation with rectal bleeding had been identified as a factor for late diagnosis of colorectal cancer. This study was conducted to determine the prevalence of delay in consulting a medical practitioner and identifying associated factors.
  
  
  METHODS
  A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The self-administered questionnaire included data on sociodemographic, concern of rectal bleeding, whether patients sought initial advice, any self treatment prior to medical consultation and patients' opinion on causes of their own rectal bleeding.
  
  
  RESULTS
  The prevalence of delay in the presentation of rectal bleeding was 60%. Patients who were less worried (OR 9.6; 95% CI 3.3-27.5), who did not seek anyoneandapos;s advice (OR 11.8; 95% CI 3.8-36.8) and took some treatment before seeking medical consultation (OR 5.0; 95% CI 1.0-24.1) were significantly more likely to delay. Multiple logistic regression revealed that less worry of rectal bleeding and not seeking anyoneandapos;s advice were important predictors (p<0.05). The majority of patients attributed their bleeding to benign causes.
  
  
  CONCLUSIONS
  A high proportion of patients with rectal bleeding in the high risk group delayed in seeking medical advice. Public education needs to focus on interventions to reduce the delay in presenting and diagnosis of colorectal carcinoma.
authors.affiliation: Department of Family Medicine, University Kebangsaan, Kuala Lumpur, Malaysia.
authors.forename: Syahnaz Mohd
authors.initials: SM
authors.lastname: Hashim
authors.forename: Khairani
authors.initials: K
authors.lastname: Omar
authors.forename: Tong Seng
authors.initials: TS
authors.lastname: Fah
authors.forename: Radzniwan Abdul
authors.initials: RA
authors.lastname: Rashid
authors.forename: Tuti Iryani
authors.initials: TI
authors.lastname: Daud
authors.forename: Shamsul Azhar
authors.initials: SA
authors.lastname: Shah
authors.forename: Ismail
authors.initials: I
authors.lastname: Sagap
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology*; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires