title: Factors influencing diagnosis of colorectal cancer: a hospital-based survey in China.
abstract: OBJECTIVE
  To investigate the diagnostic status of colorectal cancer (CRC) and the influence of early diagnosis and cancer stage in a tertiary care hospital in China.
  
  
  METHODS
  Face-to-face interviews were conducted in 364 consecutive CRC patients who had never participated in CRC screening. Initial symptoms, diagnosis and treatment delay were determined using a questionnaire. Factors influencing diagnostic status were analyzed using univariate analysis and logistic regression model.
  
  
  RESULTS
  A total of 307 patients were enrolled, in which 128 were with colon cancer and 179 with rectal cancer. The duration of diagnosis delay was significant longer than that of treatment delay. Unlike rectal cancer, colon cancer was likely to be treated at an advanced stage with a short interval between symptom onset and treatment. Colon cancer patients with a history of biliary tract or gallbladder stones, aged ≥ 50 years and with abdominal mass or intestinal obstruction as the initial symptom were diagnosed and treated much earlier. In rectal cancer, women and non-smokers were diagnosed and treated quickly. Factors correlated with early cancer stage were found in colon cancer, including bloody stool as the initial symptom (OR = 2.63, 95% CI 1.08-6.25, P = 0.034) and a history of appendectomy (OR = 4.00, 95% CI 1.15-14.29, P = 0.029).
  
  
  CONCLUSIONS
  The factors contributing to early cancer detection were identified but their clinical value is limited. Diagnosis by symptoms suggesting CRC needs to be improved and CRC screening should be vigorously promoted.
authors.affiliation: Department of Gastroenterology, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu Province, China.
authors.forename: Shang Xin
authors.initials: SX
authors.lastname: Deng
authors.forename: Wei
authors.initials: W
authors.lastname: An
authors.forename: Jie
authors.initials: J
authors.lastname: Gao
authors.forename: Jie
authors.initials: J
authors.lastname: Yin
authors.forename: Quan Cai
authors.initials: QC
authors.lastname: Cai
authors.forename: Ming
authors.initials: M
authors.lastname: Yang
authors.forename: Shang You
authors.initials: SY
authors.lastname: Hong
authors.forename: Xin Xin
authors.initials: XX
authors.lastname: Fu
authors.forename: En Da
authors.initials: ED
authors.lastname: Yu
authors.forename: Xiao Dong
authors.initials: XD
authors.lastname: Xu
authors.forename: Wei
authors.initials: W
authors.lastname: Zhu
authors.forename: Zhao Shen
authors.initials: ZS
authors.lastname: Li
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000367:Age Factors; D001062:Appendectomy; D002681:China; D003110:Colonic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D055088:Early Detection of Cancer; D005260:Female; D042882:Gallstones / Q000150:complications; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D007415:Intestinal Obstruction / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D012737:Sex Factors; D013997:Time Factors