Skip to main content
Top
Published in: BMC Gastroenterology 1/2012

Open Access 01-12-2012 | Research article

Factors associated with consultation behaviour for primary symptoms potentially indicating colorectal cancer: A cross-sectional study on response to symptoms

Authors: Ryan J Courtney, Christine L Paul, Robert W Sanson-Fisher, Finlay A Macrae, John Attia, Mark McEvoy

Published in: BMC Gastroenterology | Issue 1/2012

Login to get access

Abstract

Background

Little data exists on the factors associated with health care seeking behaviour for primary symptoms of colorectal cancer (CRC). This study aimed to identify individual, provider and psychosocial factors associated with (i) ever seeking medical advice and (ii) seeking early medical advice for primary symptoms of colorectal cancer (CRC).

Methods

1592 persons aged 56–88 years randomly selected from the Hunter Community Study (HCS) were sent a questionnaire.

Results

Males and those who had received screening advice from a doctor were at significantly higher odds of ever seeking medical advice for rectal bleeding. Persons who had private health coverage, consulted a doctor because the ‘symptom was serious’, or who did not wait to consult a doctor for another reason were at significantly higher odds of seeking early medical advice (< 2 weeks). For change in bowel habit, persons with lower income, within the healthy weight range, or who had discussed their family history of CRC irrespective of whether informed of ‘increased risk’ were at significantly higher odds of ever seeking medical advice. Persons frequenting their GP less often and seeing their doctor because the symptom persisted were at significantly higher odds of seeking early medical advice (< 2 weeks).

Conclusions

The seriousness of symptoms, importance of early detection, and prompt consultation must be articulated in health messages to at-risk persons. This study identified modifiable factors, both individual and provider-related to consultation behaviour. Effective health promotion efforts must heed these factors and target sub-groups less likely to seek early medical advice.
Appendix
Available only for authorised users
Literature
2.
go back to reference Pisani P, Parkin DM, Ferlay J: Estimates of the worldwide mortality from eighteen major cancers in 1985. Implications for prevention and projections of future burden. Int J Cancer. 1993, 55: 891-903. 10.1002/ijc.2910550604.CrossRefPubMed Pisani P, Parkin DM, Ferlay J: Estimates of the worldwide mortality from eighteen major cancers in 1985. Implications for prevention and projections of future burden. Int J Cancer. 1993, 55: 891-903. 10.1002/ijc.2910550604.CrossRefPubMed
3.
go back to reference Pisani P, Parkin DM, Bray F, Ferlay J: Estimates of the worldwide mortality from 25 cancer in 1990. Int J Cancer. 1999, 83: 18-29.CrossRefPubMed Pisani P, Parkin DM, Bray F, Ferlay J: Estimates of the worldwide mortality from 25 cancer in 1990. Int J Cancer. 1999, 83: 18-29.CrossRefPubMed
4.
go back to reference Wingo PA, Cardinez CJ, Landis SH, Greenlee RT, Ries LA, Anderson RN, Thun MJ: Long-term trends in cancer mortality in the United States, 1930–1998. Cancer. 2003, 97: 3133-3275. 10.1002/cncr.11380.CrossRefPubMed Wingo PA, Cardinez CJ, Landis SH, Greenlee RT, Ries LA, Anderson RN, Thun MJ: Long-term trends in cancer mortality in the United States, 1930–1998. Cancer. 2003, 97: 3133-3275. 10.1002/cncr.11380.CrossRefPubMed
5.
6.
go back to reference Cockburn J, Paul C, Tzelepis F, McElduff P, Byles J: Delay in seeking advice for symptoms that potentially indicate bowel cancer. Am J Health Behav. 2003, 27: 401-407. 10.5993/AJHB.27.4.12.CrossRefPubMed Cockburn J, Paul C, Tzelepis F, McElduff P, Byles J: Delay in seeking advice for symptoms that potentially indicate bowel cancer. Am J Health Behav. 2003, 27: 401-407. 10.5993/AJHB.27.4.12.CrossRefPubMed
8.
9.
go back to reference Talley NJ, Jones M: Self-reported rectal bleeding in a United States community: prevalence, risk factors, and health care seeking. Am J Gastroenterol. 1998, 93: 2179-2183. 10.1111/j.1572-0241.1998.00530.x.CrossRefPubMed Talley NJ, Jones M: Self-reported rectal bleeding in a United States community: prevalence, risk factors, and health care seeking. Am J Gastroenterol. 1998, 93: 2179-2183. 10.1111/j.1572-0241.1998.00530.x.CrossRefPubMed
10.
go back to reference Kiran PR, Glass RE: Duration of symptoms and spread of colorectal cancer: a short history does not mean early disease. Ann R Coll Surg Engl. 2002, 84: 381-385. 10.1308/003588402760978157.CrossRefPubMedPubMedCentral Kiran PR, Glass RE: Duration of symptoms and spread of colorectal cancer: a short history does not mean early disease. Ann R Coll Surg Engl. 2002, 84: 381-385. 10.1308/003588402760978157.CrossRefPubMedPubMedCentral
11.
go back to reference Majumdar S, Fletcher R, Evans A: How does colorectal cancer present? Symptoms, duration, and clues to location. Am J Gastroenterol. 1999, 94: 3039-3045. 10.1111/j.1572-0241.1999.01454.x.CrossRefPubMed Majumdar S, Fletcher R, Evans A: How does colorectal cancer present? Symptoms, duration, and clues to location. Am J Gastroenterol. 1999, 94: 3039-3045. 10.1111/j.1572-0241.1999.01454.x.CrossRefPubMed
12.
go back to reference Smith D, Ballal M, Hodder R, Soin G, Selvachandran S, Cade D: Symptomatic presentation of early colorectal cancer. Ann R Coll Surg Engl. 2006, 88: 185-190. 10.1308/003588406X94904.CrossRefPubMedPubMedCentral Smith D, Ballal M, Hodder R, Soin G, Selvachandran S, Cade D: Symptomatic presentation of early colorectal cancer. Ann R Coll Surg Engl. 2006, 88: 185-190. 10.1308/003588406X94904.CrossRefPubMedPubMedCentral
13.
go back to reference John SKP, George S, Primrose JN, Fozard JBJ: Symptoms and signs in patients with colorectal cancer. Colorectal Dis. 2010, 13: 17-25.CrossRef John SKP, George S, Primrose JN, Fozard JBJ: Symptoms and signs in patients with colorectal cancer. Colorectal Dis. 2010, 13: 17-25.CrossRef
14.
go back to reference Hamilton W, Sharp D: Diagnosis of colorectal cancer in primary care: the evidence base for guidelines. Fam Pract. 2004, 21: 99-106. 10.1093/fampra/cmh121.CrossRefPubMed Hamilton W, Sharp D: Diagnosis of colorectal cancer in primary care: the evidence base for guidelines. Fam Pract. 2004, 21: 99-106. 10.1093/fampra/cmh121.CrossRefPubMed
15.
go back to reference Korsgaard M, Pedersen L, Sorensen HT, Laurberg S: Reported symptoms, diagnostic delay and stage of colorectal cancer: a population-based study in Denmark. Color Dis. 2006, 8: 688-695. 10.1111/j.1463-1318.2006.01014.x.CrossRef Korsgaard M, Pedersen L, Sorensen HT, Laurberg S: Reported symptoms, diagnostic delay and stage of colorectal cancer: a population-based study in Denmark. Color Dis. 2006, 8: 688-695. 10.1111/j.1463-1318.2006.01014.x.CrossRef
16.
go back to reference Ramos M, Esteva M, Cabeze E, Llobera J, Ruiz A: Lack of association between diagnostic and therapeutic delay and stage of colorectal cancer. Eur J Cancer. 2008, 44: 510-521. 10.1016/j.ejca.2008.01.011.CrossRefPubMed Ramos M, Esteva M, Cabeze E, Llobera J, Ruiz A: Lack of association between diagnostic and therapeutic delay and stage of colorectal cancer. Eur J Cancer. 2008, 44: 510-521. 10.1016/j.ejca.2008.01.011.CrossRefPubMed
17.
go back to reference Ramos M, Esteva M, Cabeza E, Campillo C, Llobera J, Aguilo A, Ramos M, Esteva M, Cabeza E, Campillo C, Llobera J, Aguilo A: Relationship of diagnostic and therapeutic delay with survival in colorectal cancer: a review. Eur J Cancer. 2007, 43: 2467-2478. 10.1016/j.ejca.2007.08.023.CrossRefPubMed Ramos M, Esteva M, Cabeza E, Campillo C, Llobera J, Aguilo A, Ramos M, Esteva M, Cabeza E, Campillo C, Llobera J, Aguilo A: Relationship of diagnostic and therapeutic delay with survival in colorectal cancer: a review. Eur J Cancer. 2007, 43: 2467-2478. 10.1016/j.ejca.2007.08.023.CrossRefPubMed
18.
go back to reference Richards MA, Westcombe AM, Love SB, Littlejohns P, Ramirez AJ: Influence of delay on survival in patients with breast cancer: a systematic review. Lancet. 1999, 353: 1119-1126. 10.1016/S0140-6736(99)02143-1.CrossRefPubMed Richards MA, Westcombe AM, Love SB, Littlejohns P, Ramirez AJ: Influence of delay on survival in patients with breast cancer: a systematic review. Lancet. 1999, 353: 1119-1126. 10.1016/S0140-6736(99)02143-1.CrossRefPubMed
19.
go back to reference Macrae F: Providing colonoscopy services for the National Bowel Cancer Screening Program. Med J Aust. 2007, 186: 280-281.PubMed Macrae F: Providing colonoscopy services for the National Bowel Cancer Screening Program. Med J Aust. 2007, 186: 280-281.PubMed
20.
go back to reference Gonzalez-Hermoso F, Perez-Palma J, Marchena-Gomez J, Lorenzo-Rocha N, Medina-Arana V: Can early diagnosis of symptomatic colorectal cancer improve the prognosis?. World J Surg. 2004, 28: 716-720.CrossRefPubMed Gonzalez-Hermoso F, Perez-Palma J, Marchena-Gomez J, Lorenzo-Rocha N, Medina-Arana V: Can early diagnosis of symptomatic colorectal cancer improve the prognosis?. World J Surg. 2004, 28: 716-720.CrossRefPubMed
21.
go back to reference Kyle SM, Isbister WH, Yeong ML: Presentation, duration of symptoms and staging of colorectal carcinoma. ANZ J Surg. 1991, 61: 137-140. 10.1111/j.1445-2197.1991.tb00190.x.CrossRef Kyle SM, Isbister WH, Yeong ML: Presentation, duration of symptoms and staging of colorectal carcinoma. ANZ J Surg. 1991, 61: 137-140. 10.1111/j.1445-2197.1991.tb00190.x.CrossRef
22.
go back to reference Stapley S, Peters TJ, Sharp D, Hamilton W: The mortality of colorectal cancer in relation to the initial symptom at presentation to primary care and to the duration of symptoms: a cohort study using medical records. Br J Cancer. 2006, 95: 1321-1325. 10.1038/sj.bjc.6603439.CrossRefPubMedPubMedCentral Stapley S, Peters TJ, Sharp D, Hamilton W: The mortality of colorectal cancer in relation to the initial symptom at presentation to primary care and to the duration of symptoms: a cohort study using medical records. Br J Cancer. 2006, 95: 1321-1325. 10.1038/sj.bjc.6603439.CrossRefPubMedPubMedCentral
23.
go back to reference Olsson L, Bergkvist L, Ekbom A: Symptom duration versus survival in non-emergency colorectal cancer. Scand J Gastroenterol. 2004, 39: 252-258. 10.1080/00365520310005342.CrossRefPubMed Olsson L, Bergkvist L, Ekbom A: Symptom duration versus survival in non-emergency colorectal cancer. Scand J Gastroenterol. 2004, 39: 252-258. 10.1080/00365520310005342.CrossRefPubMed
24.
go back to reference Roncoroni L, Pietra N, Violi V, Sarli L, Choua O, Peracchia A: Delay in the diagnosis and outcome of colorectal cancer: a prospective study. Eur J Surg Oncol. 1999, 25: 173-178. 10.1053/ejso.1998.0622.CrossRefPubMed Roncoroni L, Pietra N, Violi V, Sarli L, Choua O, Peracchia A: Delay in the diagnosis and outcome of colorectal cancer: a prospective study. Eur J Surg Oncol. 1999, 25: 173-178. 10.1053/ejso.1998.0622.CrossRefPubMed
25.
go back to reference Mulcahy HE, O'Donoghue DP: Duration of colorectal cancer symptoms and survival: the effect of confounding clinical and pathological variables. Eur J Cancer. 1997, 33: 1461-1467. 10.1016/S0959-8049(97)00089-0.CrossRefPubMed Mulcahy HE, O'Donoghue DP: Duration of colorectal cancer symptoms and survival: the effect of confounding clinical and pathological variables. Eur J Cancer. 1997, 33: 1461-1467. 10.1016/S0959-8049(97)00089-0.CrossRefPubMed
26.
go back to reference Rupassara KS, Ponnusamy N, Withanage N, Milewski PJ: A paradox explained? Patients with delayed diagnosis of symptomatic colorectal cancer have good prognosis. Colorectal Dis. 2006, 8: 423-429. 10.1111/j.1463-1318.2006.00958.x.CrossRefPubMed Rupassara KS, Ponnusamy N, Withanage N, Milewski PJ: A paradox explained? Patients with delayed diagnosis of symptomatic colorectal cancer have good prognosis. Colorectal Dis. 2006, 8: 423-429. 10.1111/j.1463-1318.2006.00958.x.CrossRefPubMed
27.
go back to reference Lynch BM, Baade P, Fritschi L, Leggett B, Owen N, Pakenham K, Newman B, Aitken JF: Modes of presentation and pathways to diagnosis of colorectal cancer in Queensland. Med J Aust. 2007, 186: 288-291.PubMed Lynch BM, Baade P, Fritschi L, Leggett B, Owen N, Pakenham K, Newman B, Aitken JF: Modes of presentation and pathways to diagnosis of colorectal cancer in Queensland. Med J Aust. 2007, 186: 288-291.PubMed
28.
go back to reference Barrett J, Jiwa M, Rose P, Hamilton W: Pathways to the diagnosis of colorectal cancer: an observational study in three UK cities. Fam Pract. 2006, 23: 15-19.CrossRefPubMed Barrett J, Jiwa M, Rose P, Hamilton W: Pathways to the diagnosis of colorectal cancer: an observational study in three UK cities. Fam Pract. 2006, 23: 15-19.CrossRefPubMed
29.
go back to reference Trickett JP, Donaldson DR, Bearn PE, Scott HJ, Hassall AC: A study on the routes of referral for patients with colorectal cancer and its effect on the time to surgery and pathological stage. Colorectal Dis. 2004, 6: 428-431. 10.1111/j.1463-1318.2004.00665.x.CrossRefPubMed Trickett JP, Donaldson DR, Bearn PE, Scott HJ, Hassall AC: A study on the routes of referral for patients with colorectal cancer and its effect on the time to surgery and pathological stage. Colorectal Dis. 2004, 6: 428-431. 10.1111/j.1463-1318.2004.00665.x.CrossRefPubMed
30.
go back to reference Gunnarsson H, Holm T, Ekholm A, Olsson L: Emergency presentation of colorectal cancer is most frequent during summer. Colorectal Dis. 2010, 13: 663-638.CrossRefPubMed Gunnarsson H, Holm T, Ekholm A, Olsson L: Emergency presentation of colorectal cancer is most frequent during summer. Colorectal Dis. 2010, 13: 663-638.CrossRefPubMed
31.
go back to reference Nascimbeni R, Ngassa H, Di Fabio F, Valloncini E, Di Betta E, Salerni B: Emergency surgery for complicated colorectal cancer. A two-decade trend analysis. Digest Surg. 2008, 25: 133-139. 10.1159/000128170.CrossRef Nascimbeni R, Ngassa H, Di Fabio F, Valloncini E, Di Betta E, Salerni B: Emergency surgery for complicated colorectal cancer. A two-decade trend analysis. Digest Surg. 2008, 25: 133-139. 10.1159/000128170.CrossRef
32.
go back to reference Tekkis PP, Poloniecki JD, Thompson MR, Stamakis JD: Operative mortality in colorectal cancer: prospective national study. BMJ. 2003, 327: 1196-1201. 10.1136/bmj.327.7425.1196.CrossRefPubMedPubMedCentral Tekkis PP, Poloniecki JD, Thompson MR, Stamakis JD: Operative mortality in colorectal cancer: prospective national study. BMJ. 2003, 327: 1196-1201. 10.1136/bmj.327.7425.1196.CrossRefPubMedPubMedCentral
33.
go back to reference Cleary J, Peters TJ, Sharp D, Hamilton W: Clinical features of colorectal cancer before emergency presentation: a population-based case–control study. Fam Pract. 2007, 1: 3-6. Cleary J, Peters TJ, Sharp D, Hamilton W: Clinical features of colorectal cancer before emergency presentation: a population-based case–control study. Fam Pract. 2007, 1: 3-6.
34.
go back to reference Olsson L, Bergkvist L, Ekbom A: Symptom duration versus survival in non-emergency colorectal cancer. Scand J Gastroenterol. 2004, 39: 252-258. 10.1080/00365520310005342.CrossRefPubMed Olsson L, Bergkvist L, Ekbom A: Symptom duration versus survival in non-emergency colorectal cancer. Scand J Gastroenterol. 2004, 39: 252-258. 10.1080/00365520310005342.CrossRefPubMed
35.
go back to reference Tekkis PP, Kinsman R, Thompson MR, Stamakis JD: The Association of Coloproctology of Great Britain and Ireland study of large bowel obstruction caused by colorectal cancer. Ann Surg. 2004, 240: 76-81. 10.1097/01.sla.0000130723.81866.75.CrossRefPubMedPubMedCentral Tekkis PP, Kinsman R, Thompson MR, Stamakis JD: The Association of Coloproctology of Great Britain and Ireland study of large bowel obstruction caused by colorectal cancer. Ann Surg. 2004, 240: 76-81. 10.1097/01.sla.0000130723.81866.75.CrossRefPubMedPubMedCentral
36.
go back to reference Jestin P, Pahlman L, Glimelius B, Gunnarsson U: Cancer staging and survival in colon cancer is dependent on the quality of the pathologists' specimen examination. Eur J Cancer. 2005, 41: 2071-2078. 10.1016/j.ejca.2005.06.012.CrossRefPubMed Jestin P, Pahlman L, Glimelius B, Gunnarsson U: Cancer staging and survival in colon cancer is dependent on the quality of the pathologists' specimen examination. Eur J Cancer. 2005, 41: 2071-2078. 10.1016/j.ejca.2005.06.012.CrossRefPubMed
37.
go back to reference McArdle CS, Hole DJ: Emergency presentation of colorectal cancer is associated with poor 5-year survival. Br J Surg. 2004, 91: 605-609. 10.1002/bjs.4456.CrossRefPubMed McArdle CS, Hole DJ: Emergency presentation of colorectal cancer is associated with poor 5-year survival. Br J Surg. 2004, 91: 605-609. 10.1002/bjs.4456.CrossRefPubMed
38.
go back to reference Roncoroni L, Pietra N, Violi L, Sarli L, Choua O, Peracchia A: Delay in diagnosis and outcome of colorectal cancer: a prospective study. Eur J Surg Oncol. 1999, 25: 173-178. 10.1053/ejso.1998.0622.CrossRefPubMed Roncoroni L, Pietra N, Violi L, Sarli L, Choua O, Peracchia A: Delay in diagnosis and outcome of colorectal cancer: a prospective study. Eur J Surg Oncol. 1999, 25: 173-178. 10.1053/ejso.1998.0622.CrossRefPubMed
39.
go back to reference Thorne K, Hutchings HA, Elwyn G, Thorne K, Hutchings HA, Elwyn G: The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: a systematic literature review. BMC Health Serv Res. 2006, 6: 43-10.1186/1472-6963-6-43.CrossRefPubMedPubMedCentral Thorne K, Hutchings HA, Elwyn G, Thorne K, Hutchings HA, Elwyn G: The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: a systematic literature review. BMC Health Serv Res. 2006, 6: 43-10.1186/1472-6963-6-43.CrossRefPubMedPubMedCentral
40.
go back to reference Khattak I, Eardley NJ, Rooney PS: Colorectal cancer - a prospective evaluation of symptom duration and GP referral patterns in an inner city teaching hospital. Colorectal Dis. 2006, 8: 518-521. 10.1111/j.1463-1318.2006.00967.x.CrossRefPubMed Khattak I, Eardley NJ, Rooney PS: Colorectal cancer - a prospective evaluation of symptom duration and GP referral patterns in an inner city teaching hospital. Colorectal Dis. 2006, 8: 518-521. 10.1111/j.1463-1318.2006.00967.x.CrossRefPubMed
41.
go back to reference Chaplin A, Curless R, Thomson R, Barton R: Prevalence of lower gastrointestinal symptoms and associated consultation behaviour in a British elderly population determined by face-to-face interview. Br J Gen Pract. 2000, 50: 798-802.PubMedPubMedCentral Chaplin A, Curless R, Thomson R, Barton R: Prevalence of lower gastrointestinal symptoms and associated consultation behaviour in a British elderly population determined by face-to-face interview. Br J Gen Pract. 2000, 50: 798-802.PubMedPubMedCentral
42.
go back to reference Basaranoglu M, Celebi S, Huseyin A, Rahman S, Deveci ES, Acik Y: Prevalence and consultation behavior of self-reported rectal bleeding by face-to-face interview in an Asian Community. Digestion. 2008, 77: 10-15. 10.1159/000114827.CrossRefPubMed Basaranoglu M, Celebi S, Huseyin A, Rahman S, Deveci ES, Acik Y: Prevalence and consultation behavior of self-reported rectal bleeding by face-to-face interview in an Asian Community. Digestion. 2008, 77: 10-15. 10.1159/000114827.CrossRefPubMed
43.
go back to reference Byles JE, Redman S, Hennrikus D, Sanson-Fisher RW, Dickinson J: Delay in consulting a medical practitioner about rectal bleeding. J Epidemiol Commun H. 1992, 46: 241-244. 10.1136/jech.46.3.241.CrossRef Byles JE, Redman S, Hennrikus D, Sanson-Fisher RW, Dickinson J: Delay in consulting a medical practitioner about rectal bleeding. J Epidemiol Commun H. 1992, 46: 241-244. 10.1136/jech.46.3.241.CrossRef
44.
go back to reference Crossland A, Jones R: Rectal bleeding: prevalence and consultation behaviour. BMJ. 1995, 19: 486-488.CrossRef Crossland A, Jones R: Rectal bleeding: prevalence and consultation behaviour. BMJ. 1995, 19: 486-488.CrossRef
45.
go back to reference Kocher HM, Saunders MP: Complacency or ignorance about rectal bleeding. Colorectal Dis. 1999, 1: 332-333. 10.1046/j.1463-1318.1999.00088.x.CrossRefPubMed Kocher HM, Saunders MP: Complacency or ignorance about rectal bleeding. Colorectal Dis. 1999, 1: 332-333. 10.1046/j.1463-1318.1999.00088.x.CrossRefPubMed
46.
go back to reference Macleod U, Mitchell E, Burgess C, Macdonald S, Ramirez AJ: Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer. 2009, 101: 92-101.CrossRef Macleod U, Mitchell E, Burgess C, Macdonald S, Ramirez AJ: Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer. 2009, 101: 92-101.CrossRef
47.
go back to reference Mitchell ED, Macdonald S, Campbell NC, Weller D, Macleod U: Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic review. Br J Cancer. 2008, 98: 60-70. 10.1038/sj.bjc.6604096.CrossRefPubMed Mitchell ED, Macdonald S, Campbell NC, Weller D, Macleod U: Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic review. Br J Cancer. 2008, 98: 60-70. 10.1038/sj.bjc.6604096.CrossRefPubMed
48.
go back to reference O'Mahony M, Hegarty J: Help seeking for cancer symptoms: A review of the literature. Oncol Nurs Forum. 2009, 36: 178-184. 10.1188/09.ONF.E178-E184.CrossRef O'Mahony M, Hegarty J: Help seeking for cancer symptoms: A review of the literature. Oncol Nurs Forum. 2009, 36: 178-184. 10.1188/09.ONF.E178-E184.CrossRef
49.
go back to reference Ramos M, Arranz M, Taltavull M, March S, Cabeze E, Esteva M: Factors triggering medical consultation for symptoms of colorectal cancer and perceptions surrounding diagnosis. Eur J Canc Care. 2009, 19: 192-199.CrossRef Ramos M, Arranz M, Taltavull M, March S, Cabeze E, Esteva M: Factors triggering medical consultation for symptoms of colorectal cancer and perceptions surrounding diagnosis. Eur J Canc Care. 2009, 19: 192-199.CrossRef
50.
go back to reference Smith LK, Pope C, Botha JL: Patients' help-seeking experiences and delay in cancer presentation: a qualititative synthesis. Lancet. 2005, 366: 825-831. 10.1016/S0140-6736(05)67030-4.CrossRefPubMed Smith LK, Pope C, Botha JL: Patients' help-seeking experiences and delay in cancer presentation: a qualititative synthesis. Lancet. 2005, 366: 825-831. 10.1016/S0140-6736(05)67030-4.CrossRefPubMed
51.
go back to reference Lee V, Robinson A, Kennedy A, Tomenson B, Rogers A, Thompson D: Functional bowel disorders in primary care: Factors associated with health-related quality of life and doctor consultation. J Psychosom Res. 2008, 64: 129-139. 10.1016/j.jpsychores.2007.09.004.CrossRefPubMed Lee V, Robinson A, Kennedy A, Tomenson B, Rogers A, Thompson D: Functional bowel disorders in primary care: Factors associated with health-related quality of life and doctor consultation. J Psychosom Res. 2008, 64: 129-139. 10.1016/j.jpsychores.2007.09.004.CrossRefPubMed
52.
go back to reference Halder SLS, Macfarlane GJ, Thompson D, O'Brien SJ, Musleh M, McBeth J: Predictors of persistent gastrointestinal symptoms among presenters to primary care. Eur J Gastroenterol Hepatol. 2009, 22: 296-305.CrossRef Halder SLS, Macfarlane GJ, Thompson D, O'Brien SJ, Musleh M, McBeth J: Predictors of persistent gastrointestinal symptoms among presenters to primary care. Eur J Gastroenterol Hepatol. 2009, 22: 296-305.CrossRef
53.
go back to reference McEvoy M, Smith W, D'Este C, Duke J, Peel R, Schofield P, Scott R, Byles J, Henry D, Ewald B, Hancock S, Smith D, Attia J: Cohort profile: The Hunter Communtiy Study. Int J Epidemiol. 2010, 39: 1452-1463. 10.1093/ije/dyp343.CrossRefPubMed McEvoy M, Smith W, D'Este C, Duke J, Peel R, Schofield P, Scott R, Byles J, Henry D, Ewald B, Hancock S, Smith D, Attia J: Cohort profile: The Hunter Communtiy Study. Int J Epidemiol. 2010, 39: 1452-1463. 10.1093/ije/dyp343.CrossRefPubMed
54.
go back to reference Courtney RJ, Paul CL, Sanson-Fisher RW, Macrae F, Attia J, McEvoy M: Current state of medical-advice-seeking behaviour for symptoms of colorectal cancer: determinants of failure and delay in medical consultation. Colorectal Dis. 2012, 14: 222-229. 10.1111/j.1463-1318.2012.02881.x.CrossRef Courtney RJ, Paul CL, Sanson-Fisher RW, Macrae F, Attia J, McEvoy M: Current state of medical-advice-seeking behaviour for symptoms of colorectal cancer: determinants of failure and delay in medical consultation. Colorectal Dis. 2012, 14: 222-229. 10.1111/j.1463-1318.2012.02881.x.CrossRef
55.
go back to reference Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). Conceptual framework and item selection. Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). Conceptual framework and item selection. Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed
56.
go back to reference Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Normand SL, Manderscheid RW, Walters EE, Zaslavsky AM: Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003, 60: 184-189. 10.1001/archpsyc.60.2.184.CrossRefPubMed Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Normand SL, Manderscheid RW, Walters EE, Zaslavsky AM: Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003, 60: 184-189. 10.1001/archpsyc.60.2.184.CrossRefPubMed
58.
go back to reference Eslick GD, Kalantar JS, Talley NJ: Rectal bleeding: epidemiology, associated risk factors, and health care seeking behaviour: a population-based study. Colorectal Dis. 2009, 11: 921-926. 10.1111/j.1463-1318.2008.01721.x.CrossRefPubMed Eslick GD, Kalantar JS, Talley NJ: Rectal bleeding: epidemiology, associated risk factors, and health care seeking behaviour: a population-based study. Colorectal Dis. 2009, 11: 921-926. 10.1111/j.1463-1318.2008.01721.x.CrossRefPubMed
59.
go back to reference Talley NJ, Jones M: Self-reported rectal bleeding in a United States Community: Prevalence, risk factors, and health care seeking. Am J Gastroenterol. 1998, 93: 2179-2183. 10.1111/j.1572-0241.1998.00530.x.CrossRefPubMed Talley NJ, Jones M: Self-reported rectal bleeding in a United States Community: Prevalence, risk factors, and health care seeking. Am J Gastroenterol. 1998, 93: 2179-2183. 10.1111/j.1572-0241.1998.00530.x.CrossRefPubMed
61.
go back to reference Cuffy M, Abir F, Audisio RA, Longo WE: Colorectal cancer presenting as surgical emergencies. Surg Oncol. 2004, 13: 149-157. 10.1016/j.suronc.2004.08.002.CrossRefPubMed Cuffy M, Abir F, Audisio RA, Longo WE: Colorectal cancer presenting as surgical emergencies. Surg Oncol. 2004, 13: 149-157. 10.1016/j.suronc.2004.08.002.CrossRefPubMed
62.
go back to reference Hargarten SW, Richardson MJ, Anderson AJ, Roberts MJ: Cancer presentation in the emergency department: a failure of primary care. Am J Emerg Med. 1992, 10: 290-293. 10.1016/0735-6757(92)90004-H.CrossRefPubMed Hargarten SW, Richardson MJ, Anderson AJ, Roberts MJ: Cancer presentation in the emergency department: a failure of primary care. Am J Emerg Med. 1992, 10: 290-293. 10.1016/0735-6757(92)90004-H.CrossRefPubMed
63.
go back to reference Khattak I, Eardley NJ, Rooney PS: Colorectal cancer - a prospective evaluation of symptom duration and GP referral patterns in an inner city teaching hospital. Colorectal Dis. 2006, 8: 518-521. 10.1111/j.1463-1318.2006.00967.x.CrossRefPubMed Khattak I, Eardley NJ, Rooney PS: Colorectal cancer - a prospective evaluation of symptom duration and GP referral patterns in an inner city teaching hospital. Colorectal Dis. 2006, 8: 518-521. 10.1111/j.1463-1318.2006.00967.x.CrossRefPubMed
64.
go back to reference Juel K, Christensen K: Are men seeking medical advice too late? Contacts to general practitioners and hospital admissions in Denmark 2005. J Publ Health. 2008, 30: 111-113. 10.1093/pubmed/fdm072.CrossRef Juel K, Christensen K: Are men seeking medical advice too late? Contacts to general practitioners and hospital admissions in Denmark 2005. J Publ Health. 2008, 30: 111-113. 10.1093/pubmed/fdm072.CrossRef
65.
go back to reference Smith JA, Braunack-Mayer A, Wittert G: What do we know about men's help seeking and health servcie use?. Med J Aust. 2006, 184: 81-83.PubMed Smith JA, Braunack-Mayer A, Wittert G: What do we know about men's help seeking and health servcie use?. Med J Aust. 2006, 184: 81-83.PubMed
66.
go back to reference Eslick GD, Kalantar JS, Talley NJ: Rectal bleeding: epidemiology, associated risk factors, and health care seeking behaviour: a population-based study. Colorectal Dis. 2008, 11: 921-926.CrossRefPubMed Eslick GD, Kalantar JS, Talley NJ: Rectal bleeding: epidemiology, associated risk factors, and health care seeking behaviour: a population-based study. Colorectal Dis. 2008, 11: 921-926.CrossRefPubMed
67.
go back to reference Mitchell E, Macdonal S, Campbell NC, Weller D, Macleod U: Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic review. Br J Cancer. 2008, 98: 60-70. 10.1038/sj.bjc.6604096.CrossRefPubMed Mitchell E, Macdonal S, Campbell NC, Weller D, Macleod U: Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic review. Br J Cancer. 2008, 98: 60-70. 10.1038/sj.bjc.6604096.CrossRefPubMed
68.
go back to reference Simon AE, Waller J, Robb K, Wardle J: Patient delay in presentation of possible cancer symptoms: The contribution of knowledge and attitudes in a population sample from the United Kingdom. Canc Epidemiol Biomarkers Prev. 2010, 19: 2272-2277. 10.1158/1055-9965.EPI-10-0219.CrossRef Simon AE, Waller J, Robb K, Wardle J: Patient delay in presentation of possible cancer symptoms: The contribution of knowledge and attitudes in a population sample from the United Kingdom. Canc Epidemiol Biomarkers Prev. 2010, 19: 2272-2277. 10.1158/1055-9965.EPI-10-0219.CrossRef
69.
go back to reference Cykert S, Kissling G, Layson R, Hansen C: Health insurance does not guarantee access to primary care: a national study of physicians' acceptance of publicly insured patients. J Gen Intern Med. 1995, 10: 345-348. 10.1007/BF02599955.CrossRefPubMed Cykert S, Kissling G, Layson R, Hansen C: Health insurance does not guarantee access to primary care: a national study of physicians' acceptance of publicly insured patients. J Gen Intern Med. 1995, 10: 345-348. 10.1007/BF02599955.CrossRefPubMed
70.
go back to reference Roetzheim RG, Pal N, Gonzalez EC, Ferrante JM, Van Durme DJ, Krischer JP: Effects of health insurance and race on early detection of cancer. Am J Public Health. 2000, 90: 1746-1754.CrossRefPubMedPubMedCentral Roetzheim RG, Pal N, Gonzalez EC, Ferrante JM, Van Durme DJ, Krischer JP: Effects of health insurance and race on early detection of cancer. Am J Public Health. 2000, 90: 1746-1754.CrossRefPubMedPubMedCentral
71.
go back to reference McDavid K, Tucker TC, Sloggeett A, Coleman MP: Cancer survival in Kentucky and health insurance coverage. Arch Intern Med. 2003, 163: 2135-2144. 10.1001/archinte.163.18.2135.CrossRefPubMed McDavid K, Tucker TC, Sloggeett A, Coleman MP: Cancer survival in Kentucky and health insurance coverage. Arch Intern Med. 2003, 163: 2135-2144. 10.1001/archinte.163.18.2135.CrossRefPubMed
72.
go back to reference Kelz RR, Gimotty PA, Polsky D, Norman S, Fraker D, DeMichele A: Morbidity and mortality of colorectal carcinoma surgery differs by insurance status. Cancer. 2004, 101: 2187-2194. 10.1002/cncr.20624.CrossRefPubMed Kelz RR, Gimotty PA, Polsky D, Norman S, Fraker D, DeMichele A: Morbidity and mortality of colorectal carcinoma surgery differs by insurance status. Cancer. 2004, 101: 2187-2194. 10.1002/cncr.20624.CrossRefPubMed
73.
go back to reference Roetzheim RG, Pal N, Tennant C, Voti L, Ayanian JZ, Schwabe A, Krischer JP: Effects of health insurance and race on early detection of cancer. J Natl Canc Inst. 1999, 91: 1409-1415. 10.1093/jnci/91.16.1409.CrossRef Roetzheim RG, Pal N, Tennant C, Voti L, Ayanian JZ, Schwabe A, Krischer JP: Effects of health insurance and race on early detection of cancer. J Natl Canc Inst. 1999, 91: 1409-1415. 10.1093/jnci/91.16.1409.CrossRef
74.
go back to reference Macleod U, Mitchell ED, Burgess C, Macdonald S, Ramirez AJ: Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer. 2009, 101: 92-101.CrossRef Macleod U, Mitchell ED, Burgess C, Macdonald S, Ramirez AJ: Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer. 2009, 101: 92-101.CrossRef
78.
go back to reference Eastman P: Collaborative study aims for earlier detection of ovarian cancer in primary care. Oncol Times UK. 2010, 7: 17- Eastman P: Collaborative study aims for earlier detection of ovarian cancer in primary care. Oncol Times UK. 2010, 7: 17-
Metadata
Title
Factors associated with consultation behaviour for primary symptoms potentially indicating colorectal cancer: A cross-sectional study on response to symptoms
Authors
Ryan J Courtney
Christine L Paul
Robert W Sanson-Fisher
Finlay A Macrae
John Attia
Mark McEvoy
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2012
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/1471-230X-12-100

Other articles of this Issue 1/2012

BMC Gastroenterology 1/2012 Go to the issue