Predictors of Pre-hospital Delay among People with Colorectal Cancer

Abstract

              Colorectal cancer is one of the leading cancers among Thai people. Delay in cancer diagnosis can lead to poor prognosis and survival, and one concern is pre-hospital delay. The purpose of this study aimed to describe time delays in diagnosis including pre-hospital and in-hospital delays and examine predictors of pre-hospital delay. From June to August 2021, two hundred and forty people with colorectal cancer were recruited from three regional hospitals in Thailand. Data were collected using the Personal Information Sheet, Colorectal Cancer Knowledge Questionnaire, Modified Illness Perception Questionnaire, Healthcare Seeking Behavior Questionnaire, and Perceived Seriousness of Warning Signs and Symptoms Questionnaire. Descriptive statistics, Pearson’s and Spearman’s correlation coefficients, and multiple regression analysis were used in data analysis.
              Results revealed that total time delays in diagnosis were between 4 to 656 days. Pre-hospital delay varied between 1 to 632 days, and in-hospital delay ranged from 2 to 315 days. Medians of total time delays in diagnosis, pre-hospital delay, and in-hospital delay were 87.50 days, 32 days, and 28.50 days, respectively. Knowledge about the colorectal cancer screening method was the strongest predictor, and jointly with healthcare seeking behavior about self-medicating, illness perception including consequence of disease and symptoms, and rehappened symptoms significantly predicted and explained 48.70% of the variances in pre-hospital delay. Implications for nursing practice should focus on improving knowledge of the disease, modifying illness perceptions, and enhancing healthcare seeking behaviors to decrease pre-hospital delay. This intervention should be tested through an experimental study.