University Library
  • Login
A gateway to Melbourne's research publications
Minerva Access is the University's Institutional Repository. It aims to collect, preserve, and showcase the intellectual output of staff and students of the University of Melbourne for a global audience.
View Item 
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne Medical School
  • General Practice
  • General Practice - Research Publications
  • View Item
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne Medical School
  • General Practice
  • General Practice - Research Publications
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

    Symptoms and patient factors associated with longer time to diagnosis for colorectal cancer: results from a prospective cohort study

    Thumbnail
    Download
    published version (240.4Kb)

    Citations
    Scopus
    Web of Science
    Altmetric
    32
    29
    Author
    Walter, FM; Emery, JD; Mendonca, S; Hall, N; Morris, HC; Mills, K; Dobson, C; Bankhead, C; Johnson, M; Abel, GA; ...
    Date
    2016-08-23
    Source Title
    British Journal of Cancer
    Publisher
    NATURE PUBLISHING GROUP
    University of Melbourne Author/s
    Emery, Jonathan; Walter, Fiona
    Affiliation
    General Practice
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Walter, F. M., Emery, J. D., Mendonca, S., Hall, N., Morris, H. C., Mills, K., Dobson, C., Bankhead, C., Johnson, M., Abel, G. A., Rutter, M. D., Hamilton, W. & Rubin, G. P. (2016). Symptoms and patient factors associated with longer time to diagnosis for colorectal cancer: results from a prospective cohort study. BRITISH JOURNAL OF CANCER, 115 (5), pp.533-541. https://doi.org/10.1038/bjc.2016.221.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256408
    DOI
    10.1038/bjc.2016.221
    Abstract
    BACKGROUND: The objective of this study is to investigate symptoms, clinical factors and socio-demographic factors associated with colorectal cancer (CRC) diagnosis and time to diagnosis. METHODS: Prospective cohort study of participants referred for suspicion of CRC in two English regions. Data were collected using a patient questionnaire, primary care and hospital records. Descriptive and regression analyses examined associations between symptoms and patient factors with total diagnostic interval (TDI), patient interval (PI), health system interval (HSI) and stage. RESULTS: A total of 2677 (22%) participants responded; after exclusions, 2507 remained. Participants were diagnosed with CRC (6.1%, 56% late stage), other cancers (2.0%) or no cancer (91.9%). Half the cohort had a solitary first symptom (1332, 53.1%); multiple first symptoms were common. In this referred population, rectal bleeding was the only initial symptom more frequent among cancer than non-cancer cases (34.2% vs 23.9%, P=0.004). There was no evidence of differences in TDI, PI or HSI for those with cancer vs non-cancer diagnoses (median TDI CRC 124 vs non-cancer 138 days, P=0.142). First symptoms associated with shorter TDIs were rectal bleeding, change in bowel habit, 'feeling different' and fatigue/tiredness. Anxiety, depression and gastro-intestinal co-morbidities were associated with longer HSIs and TDIs. Symptom duration-dependent effects were found for rectal bleeding and change in bowel habit. CONCLUSIONS: Doctors and patients respond less promptly to some symptoms of CRC than others. Healthcare professionals should be vigilant to the possibility of CRC in patients with relevant symptoms and mental health or gastro-intestinal comorbidities.

    Export Reference in RIS Format     

    Endnote

    • Click on "Export Reference in RIS Format" and choose "open with... Endnote".

    Refworks

    • Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References


    Collections
    • Minerva Elements Records [45689]
    • General Practice - Research Publications [513]
    Minerva AccessDepositing Your Work (for University of Melbourne Staff and Students)NewsFAQs

    BrowseCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    My AccountLoginRegister
    StatisticsMost Popular ItemsStatistics by CountryMost Popular Authors