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New Zealanders' experiences and pathways to a diagnosis of bowel cancer: a cross-sectional descriptive study of a younger cohort.
New Zealand Medical Journal 2018 October 6
AIMS: To understand colorectal cancer (CRC) symptoms experienced by Aotearoa/New Zealand patients and to describe patient-experienced pathways and factors which may be associated with delayed diagnosis.
METHODS: Ninety-eight patients diagnosed with CRC, recruited via a national charity, completed a questionnaire. Questions included demographics, symptoms, help-seeking and diagnostic pathways followed.
RESULTS: Of 98 participants, 72 (73%) were aged under 60 years; most were symptomatic (n=93, 95%) and first discussed symptoms with someone who was not a healthcare professional (HCP) (n=71, 79%). The first HCP approached was usually a general practitioner (n=81, 83%). Symptom-to-diagnosis interval (SDI) was often six months or more (n=52, 56%) among our younger cohort. Delay was more likely if patients were younger (P=0.05), without a tertiary qualification (P=0.03), reported a poor/neutral experience at their first related HCP appointment (P=0.02), or were diagnosed in the public sector (P=0.01).
CONCLUSIONS: Few patients initially suspected bowel cancer or reported embarrassment seeking care; those who did were most likely to experience changes in bowel habit or bleeding. Our study is small, and not representative of all those diagnosed with CRC in New Zealand; yet it provides important first insights into patients' diagnostic experiences.
METHODS: Ninety-eight patients diagnosed with CRC, recruited via a national charity, completed a questionnaire. Questions included demographics, symptoms, help-seeking and diagnostic pathways followed.
RESULTS: Of 98 participants, 72 (73%) were aged under 60 years; most were symptomatic (n=93, 95%) and first discussed symptoms with someone who was not a healthcare professional (HCP) (n=71, 79%). The first HCP approached was usually a general practitioner (n=81, 83%). Symptom-to-diagnosis interval (SDI) was often six months or more (n=52, 56%) among our younger cohort. Delay was more likely if patients were younger (P=0.05), without a tertiary qualification (P=0.03), reported a poor/neutral experience at their first related HCP appointment (P=0.02), or were diagnosed in the public sector (P=0.01).
CONCLUSIONS: Few patients initially suspected bowel cancer or reported embarrassment seeking care; those who did were most likely to experience changes in bowel habit or bleeding. Our study is small, and not representative of all those diagnosed with CRC in New Zealand; yet it provides important first insights into patients' diagnostic experiences.
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