Zoe Windner1, Sue Crengle2, Brandon de Graaf3, Ari Samaranayaka4, Sarah Derrett5. 1. Student, Dunedin School of Medicine, University of Otago, Dunedin. 2. Associate Professor, Department of Preventive and Social Medicine, University of Otago, Dunedin. 3. Data Manager/Programmer, Department of Preventive and Social Medicine, University of Otago, Dunedin. 4. Biostatistician, Biostatistics Unit, Dunedin School of Medicine, University of Otago, Dunedin. 5. Professor, Department of Preventive and Social Medicine, University of Otago, Dunedin.
Abstract
AIMS: To understand colorectal cancer (CRC) symptoms experienced by Aotearoa/New Zealand patients and to describe patient-experienced pathways and factors which may be associated with delayed diagnosis. METHODS: Ninety-eight patients diagnosed with CRC, recruited via a national charity, completed a questionnaire. Questions included demographics, symptoms, help-seeking and diagnostic pathways followed. RESULTS: Of 98 participants, 72 (73%) were aged under 60 years; most were symptomatic (n=93, 95%) and first discussed symptoms with someone who was not a healthcare professional (HCP) (n=71, 79%). The first HCP approached was usually a general practitioner (n=81, 83%). Symptom-to-diagnosis interval (SDI) was often six months or more (n=52, 56%) among our younger cohort. Delay was more likely if patients were younger (P=0.05), without a tertiary qualification (P=0.03), reported a poor/neutral experience at their first related HCP appointment (P=0.02), or were diagnosed in the public sector (P=0.01). CONCLUSIONS: Few patients initially suspected bowel cancer or reported embarrassment seeking care; those who did were most likely to experience changes in bowel habit or bleeding. Our study is small, and not representative of all those diagnosed with CRC in New Zealand; yet it provides important first insights into patients' diagnostic experiences.
AIMS: To understand colorectal cancer (CRC) symptoms experienced by Aotearoa/New Zealand patients and to describe patient-experienced pathways and factors which may be associated with delayed diagnosis. METHODS: Ninety-eight patients diagnosed with CRC, recruited via a national charity, completed a questionnaire. Questions included demographics, symptoms, help-seeking and diagnostic pathways followed. RESULTS: Of 98 participants, 72 (73%) were aged under 60 years; most were symptomatic (n=93, 95%) and first discussed symptoms with someone who was not a healthcare professional (HCP) (n=71, 79%). The first HCP approached was usually a general practitioner (n=81, 83%). Symptom-to-diagnosis interval (SDI) was often six months or more (n=52, 56%) among our younger cohort. Delay was more likely if patients were younger (P=0.05), without a tertiary qualification (P=0.03), reported a poor/neutral experience at their first related HCP appointment (P=0.02), or were diagnosed in the public sector (P=0.01). CONCLUSIONS: Few patients initially suspected bowel cancer or reported embarrassment seeking care; those who did were most likely to experience changes in bowel habit or bleeding. Our study is small, and not representative of all those diagnosed with CRC in New Zealand; yet it provides important first insights into patients' diagnostic experiences.
Authors: Matthew Castelo; Colin Sue-Chue-Lam; Lawrence Paszat; Teruko Kishibe; Adena S Scheer; Bettina E Hansen; Nancy N Baxter Journal: PLoS One Date: 2022-09-12 Impact factor: 3.752