Patient delay to diagnosis and its predictors among colorectal cancer patients: A cross-sectional study based on the Theory of Planned Behavior

Purpose: The prognosis for colorectal cancer is closely related to the time of diagnosis. However, patient delay is common and become a major contributor to delays in cancer diagnosis. We aimed to investigate patient delay and its predictors based on the Theory of Planned Behavior among colorectal cancer patients. Methods: In total, 303 colorectal cancer patients were recruited from a Grade-A tertiary cancer center in southern China by convenience sampling. The participants' general information, stigma, self-efficacy, and knowledge about colorectal cancer were assessed by a self-designed general information questionnaire, the Social Impact Scale, the General Self-Efficacy Scale, and the section of the Bowel Cancer Awareness Measure on total knowledge of colorectal cancer. Descriptive statistics, univariate analysis, and binary logistic regression were applied for data analysis. Results: The median patient delay was four months (range: 1 day-10 years). The prevalence of prolonged patient delay (>= 3 months) was 57.8%. Identified by binary logistic regression, prolonged patient delay was associated with having no close family members/friends in medical professionals, unwillingness to accept colonoscopy, blood in stools, dyspepsia, insufficient support from family members, more measures taken to control symptoms, lower perceived severity of symptoms, knowledge shortage, negative help-seeking attitudes, lower self-efficacy, and higher stigma. Conclusions: Patient delay was considerable in individuals with colorectal cancer in China. Factors associated with patient delay are complex in Chinese culture. To shorten patient delay, culturally sensitive interventions may be required to improve knowledge, alleviate cancer stigma, enhance self-efficacy to seek medical attention, and promote positive help-seeking behaviors.