Patient-reported diagnostic intervals to colorectal cancer diagnosis in the Midland region of New Zealand: a prospective cohort study

• Published in: Family practice 2022-07, Vol.39 (4), p.639-647
• Main Authors: Blackmore, Tania, Chepulis, Lynne, Rawiri, Keenan, Kidd, Jacquie, Stokes, Tim, Firth, Melissa, Elwood, Mark, Weller, David, Emery, Jon, Lawrenson, Ross
• Format: Article
• Language: English
• Subjects: Health Service Research
• ISSN: 1460-2229; 0263-2136; 1460-2229
• DOI: 10.1093/fampra/cmab155

BACKGROUND AND OBJECTIVESNew Zealand (NZ) has high rates of colorectal cancer (CRC) but low rates of early detection. The majority of CRC is diagnosed through general practice, where lengthy diagnostic intervals are common. We investigated factors contributing to diagnostic delay in a cohort of patients newly diagnosed with CRC. METHODSPatients were recruited from the Midland region and interviewed about their diagnostic experience using a questionnaire based on a modified Model of Pathways to Treatment framework and SYMPTOM questionnaire. Descriptive statistics were used to describe the population characteristics. Chi-square analysis and logistic regression were used to analyse factors influencing diagnostic intervals. RESULTSData from 176 patients were analysed, of which 65 (36.9%) experienced a general practitioner (GP) diagnostic interval of >120 days and 96 (54.5%) experienced a total diagnostic interval (TDI) > 120 days. Patients reporting rectal bleeding were less likely to experience a long TDI (odds ratio [OR] 0.34, 95% confidence interval [CI]: 0.14-0.78) and appraisal/help-seeking interval (OR, 0.19, 95% CI: 0.06-0.59). Patients