Sociodemographic and Clinical Determinants of Delayed Diagnosis in Colorectal Cancer
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Abstract
Background: Colorectal cancer is a leading cause of cancer-related mortality worldwide, with delayed diagnosis contributing to advanced disease and poorer outcomes. Sociodemographic disparities and healthcare access variations influence diagnostic timelines, particularly in low- and middle-income countries where screening remains limited. Understanding delayed diagnosis is essential for improving early detection and patient prognosis.
Objective: To evaluate sociodemographic and clinical determinants associated with delayed diagnosis among colorectal cancer patients.
Method: This cross-sectional observational study was conducted at the Department of Colorectal Surgery, Bangladesh Medical University, Dhaka, from January to December 2025. Sixty histopathologically confirmed colorectal cancer patients were enrolled. Data were collected through structured interviews and hospital records. Analysis was performed using SPSS version 26.0.
Results: Most participants were aged 40–59 years (53.3%) and male (63.3%), with rural residence predominance (65.0%). Rectal bleeding was the most common symptom (40.0%). Diagnostic delay exceeding three months occurred in 61.7% of patients. Delayed diagnosis was higher among rural residents (74.4%, p=0.012), individuals without formal education (83.3%, p=0.004) and those with a monthly income below 15,000 BDT (80.8%, p=0.009). Advanced-stage disease (stage III–IV) was observed in 83.8% of patients with delayed diagnosis compared with 34.8% diagnosed within three months (p<0.001).
Conclusion: Delayed diagnosis of colorectal cancer is associated with socioeconomic disadvantage and advanced-stage presentation. Targeted awareness programs, improved healthcare access and strengthened referral systems may facilitate earlier diagnosis and better outcomes.