Factors influencing diagnosis of colorectal cancer: a hospital-based survey in China.

OBJECTIVE: To investigate the diagnostic status of colorectal cancer (CRC) and the influence of early diagnosis and cancer stage in a tertiary care hospital in China. METHODS: Face-to-face interviews were conducted in 364 consecutive CRC patients who had never participated in CRC screening. Initial symptoms, diagnosis and treatment delay were determined using a questionnaire. Factors influencing diagnostic status were analyzed using univariate analysis and logistic regression model. RESULTS: A total of 307 patients were enrolled, in which 128 were with colon cancer and 179 with rectal cancer. The duration of diagnosis delay was significant longer than that of treatment delay. Unlike rectal cancer, colon cancer was likely to be treated at an advanced stage with a short interval between symptom onset and treatment. Colon cancer patients with a history of biliary tract or gallbladder stones, aged ≥ 50 years and with abdominal mass or intestinal obstruction as the initial symptom were diagnosed and treated much earlier. In rectal cancer, women and non-smokers were diagnosed and treated quickly. Factors correlated with early cancer stage were found in colon cancer, including bloody stool as the initial symptom (OR = 2.63, 95% CI 1.08-6.25, P = 0.034) and a history of appendectomy (OR = 4.00, 95% CI 1.15-14.29, P = 0.029). CONCLUSIONS: The factors contributing to early cancer detection were identified but their clinical value is limited. Diagnosis by symptoms suggesting CRC needs to be improved and CRC screening should be vigorously promoted.

[Factors influencing patient compliance in colorectal cancer screening: qualitative research synthesis].

OBJECTIVE: To systematically collect and analyze the influencing factors of patient compliance with colorectal cancer screening in qualitative studies so as to provide a theoretical basis for improving compliance. METHODS: The databases of Pubmed, EMbase, CBMdisc, CNKI and VIP and the relevant articles were searched. According to the predefined inclusion and exclusion criteria, the qualitative studies of the influencing factors of patient compliance with screening were included. After selection and critical appraisal of the retrieved studies, a meta-analysis was performed. RESULTS: A total of 15 studies were included. It was found that several factors had a great impact on the patient compliance of screening. They included a lack of knowledge of cancer and screening, screening costs, a feeling of embarrassment, a fear of screening complications or discomfort, barriers to implementation of screening, a lack of communication with physicians and a lack of symptoms and awareness. CONCLUSION: Screening compliance may be improved through enhancing cognitive function in patients, ameliorating physician-patient communication and lowing the screening costs.