Delayed treatment for rectal cancer

Stephen L. Ristvedt, Elisa H. Birnbaum, David W. Dietz, James W. Fleshman, Ira J. Kodner, Thomas E. Read

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

PURPOSE: Reports of the relationship between length of delay before diagnosis of rectal cancer and stage of the disease have been mixed. The present study documented the magnitude and medical ramifications of delay in diagnosing rectal cancer. METHODS: One hundred twenty patients who had been recently diagnosed with rectal cancer provided information regarding history of symptoms and initial perceptions of those symptoms. Patients also estimated the time elapsed from onset of symptoms until their first consultation with a physician, as well as time elapsed from consultation until the diagnosis of rectal cancer was made. Stage information was gathered from patient charts. RESULTS: For 106 of the patients, the first sign of rectal cancer was in the form of symptoms, and the most common first symptom was rectal bleeding. For the remaining 14 patients, their cancer was first discovered through routine examination. Over 75 percent of patients with symptoms did not initially believe that they were caused by cancer or any other serious problem, and over 50 percent attributed their symptoms to hemorrhoids. There was a clear trend, albeit statistically nonsignificant, toward worsening disease with longer delays. Median delay times in weeks were Stage I (10.0 weeks), Stage II (14.0 weeks), Stage III (18.5 weeks), and Stage IV (26.0 weeks). CONCLUSIONS: Delayed diagnosis for rectal cancer remains a significant problem, with instances of delay attributable to both patient and physician. Delayed diagnosis can result in more serious disease and, when attributable to the physician, can result in damaged trust and sometimes legal action.

Original languageEnglish
Pages (from-to)1736-1741
Number of pages6
JournalDiseases of the Colon and Rectum
Volume48
Issue number9
DOIs
StatePublished - Sep 1 2005

Keywords

  • Diagnosis
  • Early diagnosis
  • Neoplasm staging
  • Rectal neoplasms

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    Ristvedt, S. L., Birnbaum, E. H., Dietz, D. W., Fleshman, J. W., Kodner, I. J., & Read, T. E. (2005). Delayed treatment for rectal cancer. Diseases of the Colon and Rectum, 48(9), 1736-1741. https://doi.org/10.1007/s10350-005-0069-x