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

Authors

  • Shang Xin Deng,

    1. Department of Gastroenterology, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu Province, China
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    • These authors contributed equally to this study.
  • Wei An,

    1. Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China
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    • These authors contributed equally to this study.
  • Jie Gao,

    1. Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China
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  • Jie Yin,

    1. Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China
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  • Quan Cai Cai,

    1. Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China
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  • Ming Yang,

    1. Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China
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  • Shang You Hong,

    1. Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China
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  • Xin Xin Fu,

    1. Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China
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  • En Da Yu,

    1. Division of Anorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
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  • Xiao Dong Xu,

    1. Division of Anorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
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  • Wei Zhu,

    1. Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China
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  • Zhao Shen Li

    Corresponding author
    • Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China
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Correspondence to: Zhao Shen LI, Department of Gastroenterology, Center for Clinical Epidemiology and Evidence-Based Medicine, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China. Email: zshen.li@gmail.com

Abstract

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.

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