Help-seeking experiences of men diagnosed with colorectal cancer: A qualitative study

6 min

Background

Colorectal cancer (CRC) is one the of most common cancers worldwide, and Australia and New Zealand together have the highest incidence and mortality rate.

Men are at greater risk of CRC and typically have a worse prognosis than women. Previous research has demonstrated a lower awareness of the risk factors for CRC among men and that they are also less likely to seek medical attention for symptoms.

Few CRC studies have been conducted with participants from Australia or have considered patients’ experiences of symptoms prior to diagnosis.

Aim

This study aimed to identify the potential reasons for delay between the onset of symptoms and the diagnosis of CRC in a group of Australian men.

Methods

The development of the interview schedule and data analysis were guided by Andersen’s Model of Total Patient Delay. This model has four stages dedicated to patient-related factors (appraisal, illness, behavioural, and scheduling delays) and one to healthcare-related factors (treatment delay).

Western Australian men who had been diagnosed with CRC in the previous 3 months were invited to participate in the study (no further recruitment details are provided). Purposive sampling was used to include a variety of ages, social backgrounds and cancer stage at diagnosis.

Semi-structured interviews were conducted February-July 2013. Participants were first asked to talk about their experiences of lower bowel symptoms from time of onset to CRC diagnosis; questions based on the theoretical model used were then asked.

Transcription and analysis took place after each interview. Participants had the opportunity to review their interview transcript for accuracy.

Results

Twenty men volunteered to participate in the study and interviews ranged from 25-35 minutes. The mean age of participants was 62.2 years (range: 27-87).

The majority of men had completed high school and two were tertiary educated. The mean time between symptom onset and first medical consultation was 7.4 months (median: 5.5).

Appraisal Delay

Illness Delay

Behavioural Delay

Scheduling and Treatment Delay

Conclusion

Diagnosis delay for CRC in men was explained by men’s inability to attribute symptoms to a condition warranting medical care and procrastination in seeking care even when it was believed to be beneficial.

Delays were further compounded by GP misdiagnosis and long waiting times for colonoscopy. The findings of this study support the need for development of interventions targeted at men and GPs to reduce diagnostic delays for CRC at the primary care level.

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