Factors contributing to time to diagnosis in symptomatic colorectal cancer: A scoping review

Colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women worldwide, and delayed diagnosis is associated with mortality. This study explored factors associated with time to diagnosis in symptomatic CRC using scoping review methods. 31 studies were identified and within these studies, 17 factors which impacts time to diagnosis were identified. Provider factors, including primary care provider as the type of medical provider seen at first visit, and provider delayed making referral to specialist, were associated with a longer time to diagnosis. Other factors such as female sex, non-urgent referral, tumour location (rectum) and patient perception that their symptoms are benign were all associated with an increased time to diagnosis. Patient or disease factors were well studied. However, provider factors, organisation/practice setting factors are poorly represented in the literature. Future studies should investigate a possible causal relationship between these factors and the diagnostic interval, especially as patients often present to primary care providers as the first point of contact.

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