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FACTORS AFFECTING DELAY IN DIAGNOSIS OF COLORECTAL CANCER: A CROSS-SECTIONAL STUDY; FROM TERTIARY CARE HOSPITAL OF KARACHI PAKISTAN
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  • Rubab Nafees Ahmed,
  • Lajpat Rai,
  • Khursheed Ahmed Samo,
  • Summaya Saeed,
  • Ammara Salam,
  • Hina Khan,
  • Amjad Siraj Memon
Rubab Nafees Ahmed
Dow University of Health Sciences
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Lajpat Rai
Dow University of Health Sciences
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Khursheed Ahmed Samo
Dow University of Health Sciences
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Summaya Saeed
Dow University of Health Sciences
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Ammara Salam
Fazaia Ruth Pfau Medical College
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Hina Khan
Dow University of Health Sciences
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Amjad Siraj Memon
Dow University of Health Sciences
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Abstract

Background: CRC incidence is increasing in our region. There is no specific CRC control program or national cancer registry in Pakistan. Previously no data has been published on presentation and diagnosis delay of CRC in our region. This study is conducted to determine the factor affecting delay in presentation and diagnosis and to provide baseline information to launch a CRC control program. Primary objective is to determine factor causing delay in diagnosis of CRC. Secondary objective is to evaluate relationship between tumor site and stage of CRC with presenting symptoms and symptom duration. Methods: This project is a prospective cross-sectional study on 113 biopsy-proven CRC patients admitted to the surgical ward of civil hospital Karachi. Results: A total number of participants was 113. Presentation delay was observed in 83.2% of patients. The main reasons for a reported delay in the presentation were lack of patients’ knowledge that these symptoms may be cancer (60.4%), the wrong diagnosis by the primary physician (34.6%), or the patient didn’t want to visit the doctor (0.04%). Most tumors (95%) originated from the sigmoid and rectum. 38.9% and 44.2% of the patients diagnosed at Stage 4 and 3 respectively. Conclusions: This study revealed that CRC patients in Pakistan are facing delays in presentation and diagnosis. This is the reason behind diagnosis at the advanced stage with a poor prognosis. Based on this study findings CRC control program should be introduced to detect CRC at an early stage. Keywords: Colorectal cancer, Colon, Rectum, Cancer, Presentation delay, Diagnosis delay.

Peer review status:ACCEPTED

13 Feb 2021Submitted to International Journal of Clinical Practice
15 Feb 2021Submission Checks Completed
15 Feb 2021Assigned to Editor
20 Apr 2021Reviewer(s) Assigned
03 May 2021Review(s) Completed, Editorial Evaluation Pending
26 May 20211st Revision Received
31 May 2021Review(s) Completed, Editorial Evaluation Pending
31 May 2021Submission Checks Completed
31 May 2021Assigned to Editor
05 Jun 2021Reviewer(s) Assigned
13 Jun 2021Editorial Decision: Accept