Patient-reported Diagnostic Intervals to Colorectal Cancer Diagnosis in the Midland Region of New Zealand: A Prospective Cohort Study

aut.relation.journalFamily Practiceen_NZ
aut.researcherKidd, Jacqueline
dc.contributor.authorBlackmore, Ten_NZ
dc.contributor.authorChepulis, Len_NZ
dc.contributor.authorRawiri, Ken_NZ
dc.contributor.authorKidd, Jen_NZ
dc.contributor.authorStokes, Ten_NZ
dc.contributor.authorFirth, Men_NZ
dc.contributor.authorElwood, Men_NZ
dc.contributor.authorWeller, Den_NZ
dc.contributor.authorEmery, Jen_NZ
dc.contributor.authorLawrenson, Ren_NZ
dc.date.accessioned2023-01-27T01:50:33Z
dc.date.available2023-01-27T01:50:33Z
dc.date.copyright2021en_NZ
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.en_NZ
dc.identifier.citationFamily Practice, 39(4), 639–647. https://doi.org/10.1093/fampra/cmab155
dc.identifier.doi10.1093/fampra/cmab155en_NZ
dc.identifier.issn0263-2136en_NZ
dc.identifier.issn1460-2229en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/15849
dc.languageengen_NZ
dc.publisherOxford University Pressen_NZ
dc.relation.urihttps://academic.oup.com/fampra/article/39/4/639/6454260
dc.rights.accessrightsOpenAccessen_NZ
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectbowelen_NZ
dc.subjectcolorectal canceren_NZ
dc.subjectdelayed diagnosisen_NZ
dc.subjectgeneral practiceen_NZ
dc.subjectNew Zealanden_NZ
dc.subjectquestionnaireen_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
pubs.elements-id445751
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Faculty of Health & Environmental Science
pubs.organisational-data/AUT/Faculty of Health & Environmental Science/School of Clinical Sciences
pubs.organisational-data/AUT/Faculty of Health & Environmental Science/School of Clinical Sciences/Nursing Department
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