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

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dc.contributor.authorBlackmore, Tania Louise en_NZ
dc.contributor.authorChepulis, Lynne Merranen_NZ
dc.contributor.authorRawiri, Keenanen_NZ
dc.contributor.authorKidd, Jacquieen_NZ
dc.contributor.authorStokes, Tim E.en_NZ
dc.contributor.authorFirth, Melissaen_NZ
dc.contributor.authorElwood, Marken_NZ
dc.contributor.authorWeller, Daviden_NZ
dc.contributor.authorEmery, Jonen_NZ
dc.contributor.authorLawrenson, Rossen_NZ
dc.date.accessioned2022-09-19T09:23:17Z
dc.date.available2022-09-19T09:23:17Z
dc.date.issued2021en_NZ
dc.description.abstractBackground and objectives New 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. Methods Patients 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. Results Data 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 <60 were more likely to report a longer appraisal/help-seeking interval (OR, 3.32, 95% CI: 1.17–9.46). Female (OR, 2.19, 95% CI: 1.08–4.44) and Māori patients (OR, 3.18, 95% CI: 1.04–9.78) were more likely to experience a long GP diagnostic interval. Conclusion NZ patients with CRC can experience long diagnostic intervals, attributed to patient and health system factors. Young patients, Māori, females, and patients experiencing change of bowel habit may be at particular risk. We need to increase symptom awareness of CRC for patients and GPs. Concentrated efforts are needed to ensure equity for Māori in access to screening, diagnostics, and treatment.
dc.format.mimetypeapplication/pdf
dc.identifier.doi10.1093/fampra/cmab155en_NZ
dc.identifier.eissn1460-2229en_NZ
dc.identifier.issn0263-2136en_NZ
dc.identifier.urihttps://hdl.handle.net/10289/15189
dc.language.isoenen_NZ
dc.publisherOxford University Pressen_NZ
dc.relation.isPartOfFamily Practiceen_NZ
dc.rights© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
dc.subjectScience & Technologyen_NZ
dc.subjectLife Sciences & Biomedicineen_NZ
dc.subjectPrimary Health Careen_NZ
dc.subjectMedicine, General & Internalen_NZ
dc.subjectGeneral & Internal Medicineen_NZ
dc.subjectcolorectal canceren_NZ
dc.subjectgeneral practiceen_NZ
dc.subjectdelayed diagnosisen_NZ
dc.subjectbowelen_NZ
dc.subjectNew Zealanden_NZ
dc.subjectquestionnaireen_NZ
dc.subjectGENERAL-PRACTICEen_NZ
dc.subjectSYMPTOMSen_NZ
dc.subjectEXPERIENCESen_NZ
dc.subjectDELAYen_NZ
dc.subjectTIMEen_NZ
dc.subjectYOUNGERen_NZ
dc.subjectSEEKINGen_NZ
dc.subjectRISKen_NZ
dc.titlePatient-reported diagnostic intervals to colorectal cancer diagnosis in the Midland region of New Zealand: a prospective cohort studyen_NZ
dc.typeJournal Article
dspace.entity.typePublication
pubs.begin-page639
pubs.end-page647
pubs.issue4en_NZ
pubs.publication-statusPublisheden_NZ
pubs.volume39en_NZ
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