Factors affecting delay in diagnosis of colorectal cancer: A cross-sectional study from a tertiary care hospital of Karachi, Pakistan

Int J Clin Pract. 2021 Oct;75(10):e14529. doi: 10.1111/ijcp.14529. Epub 2021 Jul 3.

Abstract

Background: Colorectal cancer (CRC) incidence is increasing in our region. There is no specific CRC control programme or national cancer registry in Pakistan. Previously, no data have been published on presentation delay and diagnosis delay of CRC in our region. This study is conducted to determine the factors affecting delay in presentation and diagnosis and to provide baseline information to launch a CRC control programme. The primary objective is to determine factors causing delay in diagnosis of CRC. The secondary objective is to evaluate the relationship between tumour site and stage of CRC with presenting symptoms and symptom duration.

Methods: This project is a prospective cross-sectional study on 113 biopsy-proven CRC patients admitted to the surgical ward of Civil Hospital Karachi.

Results: The total number of participants was 113. Presentation delay was observed in 83.2% of patients. The main reasons for a reported delay in the presentation were lack of patients' knowledge that these symptoms may be cancer (60.4%), the wrong diagnosis by the primary physician (34.6%) or the patient did not want to visit the doctor (0.04%). Most tumours (95%) originated from the sigmoid and rectum; 44.2% and 38.9% of the patients were diagnosed at Stages 3 and 4, respectively.

Conclusions: This study revealed that CRC patients in Pakistan are facing delays in presentation and diagnosis. This is the reason behind diagnosis at the advanced stage with a poor prognosis. On the basis of this study findings, CRC control programme should be introduced to detect CRC at an early stage.

MeSH terms

  • Colorectal Neoplasms* / diagnosis
  • Colorectal Neoplasms* / epidemiology
  • Cross-Sectional Studies
  • Humans
  • Pakistan / epidemiology
  • Prospective Studies
  • Tertiary Care Centers