title: Delay in Presentation, Diagnosis and Treatment for Colorectal Cancer Patients in Jordan.
abstract: OBJECTIVE
  Colorectal cancer (CRC) ranked first among cancers reported in males and second among cancers reported in females in Jordan in 2010. There has been no specific CRC-control programme in Jordan. Additionally, there has been no published study from Jordan or its neighbours on patient delays in presentation, diagnosis or treatment. Therefore, we conducted this study to assess these important quality indicators aiming to improve prognosis for CRC and to provide baseline data for future health promotion programmes for CRC in Jordan.
  
  
  METHODS
  This project was a cross-sectional study on CRC patients at Al Bashir Hospital, Ministry of Health, and at the Military Oncology Centre of the Jordanian Royal Medical Services.
  
  
  RESULTS
  The total number of participants was 189. The proportion of patients with presentation delay, diagnosis delay or treatment delay was 33.9, 68.1 and 32.6%, respectively. The main reasons reported for delay in presentation were lack of knowledge that symptoms were suggestive of cancer (58.5%), misdiagnosis by physicians or pharmacists (38.4%) or the patient did not want to visit a doctor (3.1%). Predictors of delay and mean time for presentation, diagnosis and treatment were identified.
  
  
  CONCLUSIONS
  Our results revealed that CRC patients in Jordan experience delays in presentation, Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation diagnosis, and, to a lesser degree, in treatment. This could justify the advanced stages at diagnosis and poor outcomes for CRC patients. Our findings provide baseline information for future CRC-control programmes in Jordan. We recommend that CRC prevention programmes in Jordan focus on early detection of CRC and target both patients and physicians.
authors.affiliation: Department of Public Health, Faculty of Medicine, Mutah University, Mutah 61710, Karak, Jordan. mabuhelalah@yahoo.co.uk.
authors.forename: Munir Ahmad
authors.initials: MA
authors.lastname: Abu-Helalah
authors.affiliation: Department of Industrial Engineering, Faculty of Engineering, Jordan University of Science and Technology, Irbid, Jordan.
authors.forename: Hussam Ahmad
authors.initials: HA
authors.lastname: Alshraideh
authors.affiliation: Ministry of Health, Karak Teaching Hospital, Karak, Jordan.
authors.forename: Moh'd
authors.initials: M
authors.lastname: Da'na
authors.affiliation: Oncology Center, Royal Medical Services, Amman, Jordan.
authors.forename: Mo'tasem
authors.initials: M
authors.lastname: Al-Hanaqtah
authors.affiliation: Ministry of Health, AlBashir Teaching Hospital, Ammam, Jordan.
authors.forename: Anas
authors.initials: A
authors.lastname: Abuseif
authors.affiliation: Directorate of Non-Communicable Diseases, Ministry of Health Jordan, Ammam, Jordan.
authors.forename: Kamal
authors.initials: K
authors.lastname: Arqoob
authors.affiliation: Department of Radiation Oncology, AlBashir Hospital, Ministry of Health, Amman, Jordan.
authors.forename: Abdelrahman
authors.initials: A
authors.lastname: Ajaj
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007597:Jordan; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011795:Surveys and Questionnaires; D061665:Time-to-Treatment / Q000706:statistics & numerical data*
keywords: Cancer; Colon; Diagnosis delay; Jordan; Presentation delay; Rectum; Treatment delay