Why so late?!--delay in treatment of colorectal cancer is socially determined

Langenbecks Arch Surg. 2010 Nov;395(8):1017-24. doi: 10.1007/s00423-010-0664-8. Epub 2010 Jun 27.

Abstract

Purpose: The interval between symptom onset and therapy in patients with colorectal cancer was studied.

Methods: One hundred twenty three patients with colorectal cancer were included. Demography data, symptoms, consultations, and tumour stage were obtained by standardized questionnaires. Risk factors for delayed treatment were analysed.

Results: Eighty six patients suffered from colonic cancer. The total time between the first symptoms and therapy ranged from 13 to 442 days (mean, 148). Delay of surgical therapy was responsible for significantly higher tumour grades. Delayed start of therapy was found to be correlated to the type of cancer, socioeconomic status, marital status, and quality of first consultation (univariate analysis). On multivariate analyses, type of cancer, marital and socioeconomic status remained significantly associated with delayed treatment (all p values ≤ 0.001, r(2) = 0.50).

Conclusions: The delay in treatment of colorectal cancer depends on socioeconomic status and family background. Achieving equity in colorectal cancer detection may require consideration of high-risk subgroups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Colectomy
  • Colonic Neoplasms / diagnosis*
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / psychology
  • Colonic Neoplasms / surgery*
  • Delayed Diagnosis*
  • Female
  • Health Services Accessibility
  • Humans
  • Male
  • Marital Status
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Rectal Neoplasms / diagnosis*
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / psychology
  • Rectal Neoplasms / surgery*
  • Referral and Consultation
  • Socioeconomic Factors
  • Tumor Burden