Barriers and facilitators to colorectal cancer diagnosis in New Zealand: a qualitative study

New Zealand (NZ) has high rates of colorectal cancer but low rates of early diagnosis. A lack of understanding of the pre-diagnostic experience from the patient’s perspective has prompted researchers to investigate potential patient and health system factors that contribute to longer diagnostic intervals in NZ.  Twenty-eight participants, diagnosed with colorectal cancer, were interviewed about their experience. They found that when symptoms were normalised, intermittent, isolated in occurrence, or if symptoms were self-managed successfully, help-seeking was delayed. However if symptoms worsened, or disrupted their work and daily routine, help was sought. Participants positively appraised GPs if they showed good technical competence and were proactive in investigating symptoms. Negative GP appraisals were associated with a lack of physical examinations and misdiagnosis. Māori participants often appraised symptoms inclusive of their sociocultural environment and considered the impact of their symptoms in relation to family. This is the first study to explore diagnostic delays using The Model of Pathways to Treatment in NZ. These findings help to understand the lived experience of the CRC diagnosis in the NZ population as well as identify barriers and facilitators present in the diagnostic experience.

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