BACKGROUND: Early detection and treatment is important for the management of colorectal cancer (CRC). AIM: To assess patient and doctor delay and their determinants. METHODS: A retrospective observational study in a primary care setting concerning 197 patients with CRC. The time between initial symptoms and the onset of treatment was categorized into four periods. With multivariable logistic regression analysis, determinants of delay were investigated. RESULTS: The median time from onset of symptoms until the start of treatment was 138 days. Median time for the four periods to: first general practitioner consult, first specialist consult, histological diagnosis, and start treatment were 30, 14, 27, and 18 days, respectively. Rectal blood loss and weight loss were significantly related to patient delay, whereas psychiatric comorbidity was related to delay in referral by the general practitioner. For delay in histological diagnosis and start of definitive treatment no determinants were found. Delay was not associated with more advanced disease stages. CONCLUSION: There is considerable delay in the management of CRC, especially in time to consultation and time to onset of clinical treatment. Education among the general public about the importance of alarm symptoms and increasing efficiency of the diagnostic process in hospital setting are a key in improving CRC disease management.
BACKGROUND: Early detection and treatment is important for the management of colorectal cancer (CRC). AIM: To assess patient and doctor delay and their determinants. METHODS: A retrospective observational study in a primary care setting concerning 197 patients with CRC. The time between initial symptoms and the onset of treatment was categorized into four periods. With multivariable logistic regression analysis, determinants of delay were investigated. RESULTS: The median time from onset of symptoms until the start of treatment was 138 days. Median time for the four periods to: first general practitioner consult, first specialist consult, histological diagnosis, and start treatment were 30, 14, 27, and 18 days, respectively. Rectal blood loss and weight loss were significantly related to patient delay, whereas psychiatric comorbidity was related to delay in referral by the general practitioner. For delay in histological diagnosis and start of definitive treatment no determinants were found. Delay was not associated with more advanced disease stages. CONCLUSION: There is considerable delay in the management of CRC, especially in time to consultation and time to onset of clinical treatment. Education among the general public about the importance of alarm symptoms and increasing efficiency of the diagnostic process in hospital setting are a key in improving CRC disease management.
Authors: Charlotte J L Molenaar; Loes Janssen; Donald L van der Peet; Desmond C Winter; Rudi M H Roumen; Gerrit D Slooter Journal: World J Surg Date: 2021-04-03 Impact factor: 3.352
Authors: Antonieta Medina-Lara; Bogdan Grigore; Ruth Lewis; Jaime Peters; Sarah Price; Paolo Landa; Sophie Robinson; Richard Neal; William Hamilton; Anne E Spencer Journal: Health Technol Assess Date: 2020-11 Impact factor: 4.014
Authors: Daniel Jones; Erica Di Martino; Stephen H Bradley; Blessing Essang; Scott Hemphill; Judy M Wright; Cristina Renzi; Claire Surr; Andrew Clegg; Richard Neal Journal: Br J Gen Pract Date: 2022-06-16 Impact factor: 6.302
Authors: Zeta Chow; Patrick Osterhaus; Bin Huang; Quan Chen; Nancy Schoenberg; Mark Dignan; B Mark Evers; Avinash Bhakta Journal: J Surg Res Date: 2020-10-20 Impact factor: 2.192
Authors: Nicole F van Erp; Charles W Helsper; Saskia M Olyhoek; Ramon R T Janssen; Amber Winsveen; Petra H M Peeters; Niek J de Wit Journal: Ann Fam Med Date: 2019-09 Impact factor: 5.166
Authors: Chanpreet S Arhi; Elaine M Burns; Alex Bottle; George Bouras; Paul Aylin; Paul Ziprin; Ara Darzi Journal: Br J Gen Pract Date: 2020-06-25 Impact factor: 5.386
Authors: Sara C Keller; Florence Momplaisir; Vincent Lo Re; Craig Newcomb; Qing Liu; Sarah J Ratcliffe; Judith A Long Journal: AIDS Care Date: 2013-11-05