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TITLE:

FACTORS ACCOUNTABLE FOR POSTPONEMENT IN TREATMENT AND DIAGNOSIS OF COLORECTAL CARCINOMA

AUTHORS:

Dr. Shahzeb, Dr. Manzar Ameen, Dr. Muhammad Shoaib Younas

ABSTRACT:

Aim: To investigate the various factors responsible for delays in the diagnosis and treatment of colorectal cancer. Place and Duration of study: In the Surgical Unit-II of Jinnah Hospital, Lahore for one-year duration from May 2019 to May 2020. Study design: Descriptive case series study. Methods: A study of 110 patients with various symptoms but ultimately diagnosed with colorectal cancer was conducted to see delaying factors. Patient demographics and various factors responsible for delayed presentation, including socioeconomic status, illiteracy, unbelief, spiritual healers, quacks, delayed referrals from general practitioners, and inadequate evaluation of consultants were statistically analyzed in SPSS version 16. For multivariate analysis, the ANNOVA for age and Fischer's exact test for gender, literacy and place of residence were used, and a p value of <0.05 was considered significant. Results: Delay in diagnosis and treatment of colorectal cancer was found in 56.2% of cases. The overall mean delay in diagnosis was 167 + 21 days, with 114 +10 days relating to patient seeking. The physician delay was 48 +19 days and the hospital / administrative delay was 15 + 7 days. Young (p-value 0.015) rural low-socioeconomic patients (p-value 0.007) with misconception were more likely to experience patient-related delays. Conclusion: The delay in seeking adequate medical care appeared to be psychosocial at the patient level, with neglect at the physician level rather than the failure to treat colorectal cancer in institutions. Key words: colorectal cancer, diagnosis, delaying factors.

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