Knowledge of Colorectal Cancer among Patients Presenting with Rectal Bleeding and its Association with Delay in Seeking Medical Advice

Hashim, Syahnaz Mohd;Fah, Tong Seng;Omar, Khairani;Rashid, Mohd Radzniwan Abdul;Shah, Shamsul Azhar;Sagap, Ismail

  • Published : 20110800

Abstract

Background: Knowledge is believed to be a driving factor for patients' early presentation for healthcare. This study was conducted to assess knowledge of colorectal cancer among subjects presenting with rectal bleeding and to determine its association with late presentation. Methods: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The research instruments used in this study was a self-administered questionnaire including data on duration of rectal bleeding, first medical consultation and knowledge of colorectal cancer. Results: Sixty percent of subjects with rectal bleeding delayed seeking medical advice. Subjects were more aware of symptoms of non-colorectal cancers compared to symptoms of colorectal cancer. The majority of subjects (63.8%) correctly identified rectal bleeding as a symptom but were not aware of the best screening method to detect colorectal cancer. Half of the subjects knew increasing age and genetic background to be risk factors for colorectal carcinoma. However, knowledge of colorectal cancer was not found to be significantly associated with delay in seeking help. Conclusion: Findings indicate poor awareness of colorectal cancer among the subjects. Although public education of colorectal cancer is important for early presentation on rectal bleeding, further studies are advocated to evaluate other factors influencing patients' help seeking behavior other than knowledge.

Keywords

References

  1. Bray F, Sankilla R, Ferlay J, et al (2002). Estimates of cancer incidence and mortality in Europe in 1995. Eur J Cancer, 38, 99-166. https://doi.org/10.1016/S0959-8049(01)00350-1
  2. Breslow RA, Sorkin JD, Frey CM, et al (1997). American's knowledge of Cancer Risk and Survival. Prev Med, 26, 170-7. https://doi.org/10.1006/pmed.1996.0136
  3. Burgess C, Hunter MS, Ramirez AJ (2001). A qualitative study of delay among women reporting symptoms of breast cancer. Br J Gen Pract, 51, 967-71.
  4. Cockburn J, Paul C, Tzelepis F, et al (2003). Delay in seeking advice for symptoms that potentially indicate bowel cancer. Am J Health Behavior, 27, 401-7. https://doi.org/10.5993/AJHB.27.4.12
  5. Dent OF, Goulston KJ, Tennant CC, et al (1990). Rectal bleeding. Patient delay in presentation. Dis Colon Rectum, 33, 851-7. https://doi.org/10.1007/BF02051921
  6. Facione NC, Miaskowski C, Dodd MJ, et al (2002). The self-reported likelihood of patient delay in breast cancer: New thoughts for early detection. Prev Med, 34, 397-407. https://doi.org/10.1006/pmed.2001.0998
  7. Ferraris R, Senore C, Fracchia M, et al (2004). Predictive value of rectal bleeding for distal colonic neoplastic lesions in a screened population. Eur J Cancer, 40, 245-52. https://doi.org/10.1016/j.ejca.2003.08.002
  8. Fishbein M (2008). A reasoned action approach to health promotion. Med Decis Making, 28, 834-44. https://doi.org/10.1177/0272989X08326092
  9. Guile K, Nicholson S (2004). Does knowledge influence melanoma-prone behavior? Awareness, exposure and sun protection among five social groups. Oncol Nurs Forum, 31, 641-6. https://doi.org/10.1188/04.ONF.641-646
  10. Hashim SH, Omar K, Seng Fah T, et al (2010). Factors influencing late consultation among patients with rectal bleeding in University Kebangsaan Malaysia Medical Centre. Asian Pacific J Cancer Prev, 11, 1335-9.
  11. Keighley MRB, O'Morain C, Giacosa A, et al (2004). Public awareness of risk factors and screening for colorectal cancer in Europe. Eur J Cancer Prev, 13, 257-62. https://doi.org/10.1097/01.cej.0000136575.01493.9b
  12. Langebach MR, Schmidt J, Neumann J, et al (2003). Delay in treatment of colorectal cancer: multifactorial problem. World J Surg, 27, 304-8. https://doi.org/10.1007/s00268-002-6678-9
  13. Lim GCC, Halimah Y (2004). Second Report of the National Cancer Registry. National Cancer Registry Kuala Lumpur
  14. Majmudar SR, Fletcher RH, Evans AT (1999). How does colorectal cancer present? Symptoms, duration and clues to location. Am J Gastroenterol, 10, 3039-45.
  15. McCaffery K, Wardle J, Waller J (2003). Knowledge, attitudes and behavioral intentions in relation to the early detection of colorectal cancer in the United Kingdom. Prev Med, 36, 525-35. https://doi.org/10.1016/S0091-7435(03)00016-1
  16. Ministry of Finance of Malaysia. 2007. Poverty Line Income.
  17. Nooijer JD, Lechner L, Vries HD (2001). A qualitative study on detecting cancer symptoms and seeking medical help; an application of Andersen's model of total patient delay. Patient Educ Counsel, 42, 145-7. https://doi.org/10.1016/S0738-3991(00)00104-X
  18. Nooijer JD, Lechner L, Vries HD (2002). Early detection of cancer: knowledge and behavior among Dutch adults. Cancer Detect Prev, 26, 362-9. https://doi.org/10.1016/S0361-090X(02)00121-6
  19. Norrelund N, Norrelund H (1996). Colorectal cancer and polyps in patients aged 40 years and over who consult a GP with rectal bleeding. Fam Pract, 13, 160-5. https://doi.org/10.1093/fampra/13.2.160
  20. Rashid MR, Aziz AF, Ahmad S, et al (2009). Colorectal cancer patients in a tertiary referral centre in Malaysia: a five year follow up. Asian Pacific J Cancer Prev, 10, 1163-6.
  21. Roncoroni L, Pietra N, Sarli L, et al (1999). Delay in the diagnosis and outcome of colorectal cancer: a prospective study. Eur J Surg Oncol, 25, 173-8. https://doi.org/10.1053/ejso.1998.0622
  22. Sheikh I, Ogden J. (1998) The role of knowledge and beliefs in help seeking behavior for cancer: a quantitative and qualitative approach. Patient Educ Counsel, 35, 35-42. https://doi.org/10.1016/S0738-3991(98)00081-0
  23. Shokar NK, Vernon SW, Weller SC (2005). Cancer and Colorectal Cancer: Knowledge, Beliefs and Screening Preferences of a Diverse Patient Population. Fam Med, 37, 341-7.
  24. Unger-Saldana K, Infante-Castaneda C (2009). Delay of medical care for symptomatic breast cancer: A literature review. Salud Publica Mex, 51, S270-85. https://doi.org/10.1590/S0036-36342009000800018
  25. Van De Kar A, Knottnerus A, Meertens R, et al (1992). Why do patients consult their general practitioner? Determinants of their decisions. Br J Gen Pract, 42, 313-6.
  26. Van Den Kerkhof EG, Milne B, Parlow JL (2003). Knowledge and practice regarding prophylactic perioperative beta blockade in patients undergoing noncardiac surgery: A survey of Canadian Anesthesiologists. Anesth Analg, 96, 1558-65.
  27. Wong BCY, Chan AO, Wong WM, et al (2006). Attitudes and knowledge of colorectal cancer and screening in Hong Kong: A population based study. J Gastroenterol Hepatol, 21, 41-6. https://doi.org/10.1111/j.1440-1746.2005.04000.x
  28. Wong NY, Nenny S, Guy RJ, et al (2002). Adults in a high risk area are unaware of the importance of colorectal cancer. A telephone and mail survey. Dis Colon Rectum, 45, 946-54. https://doi.org/10.1007/s10350-004-6334-6
  29. Yardley C, Glover C, Allen-Mersh TG (2000). Demographic factors associated with knowledge of colorectal cancer symptoms in a UK population-based survey. Ann R Coll Surg Engl, 82, 205-9.