Abstract:
BACKGROUND: Colorectal cancer is the third most common leading cause of cancer related death worldwide. It is also a major cause of morbidity and mortality. Surgery is the mainstay of the treatment. Delay in diagnosis can affect outcomes of patients and it can be related to the health care personnel or to patients. This study described the factors that affect delay in CRC cancer diagnosis and it described early postoperative outcomes for operated patients.
METHODS: This was a descriptive prospective observational hospital based study that evaluated patterns of diagnosis delay in patients with CRC. Information from the patients was collected on questionnaire on their arrival at CHUK and operated ones were followed within 30 days. Outcomes were measured in hospital and after discharge from the day of operation till day 30 and pathology results were recorded.
RESULTS: 72 patients were recruited with confirmed CRC and 2 of them were missed for follow up; of the 70 remained, 39 (55.7%)were males and 31(44.3%) females, the mean age was 56.09 from 21 years to 85 years. The most frequent symptoms were rectal bleeding; abdominal pain and change in bowel habits with 74.2%, 45.7%, and 42.9% respectively. The patients’ majority presented with one or more symptoms. The mean duration of symptoms at presentation was 14.6 months and 50% of patients presented with symptoms lasting for >12 months. The patterns of delays were: delay to consult (5.7 month), referral delay and delay (delay at 1st health care facility: mean =3 months and delay at district hospital mean= 3.1 months) at CHUK (mean = 4.3 months). Health insurance and clinical presentation of CRC were significantly associated with diagnostic delay. 58 (82.8%) of patients were operated. Abdominal perineal resection and low anterior resection were popular in 41.4% with 4% mortality rate. Other procedures were polypectomy, right hemicolectomy, left hemicolectomy and palliative stoma. There was no significant difference in outcomes for all procedure performed in this study.
CONCLUSION: CRC prevalence is increasing in Rwandan population; more often its diagnosis is delayed by several factors, related to patients and health care personnel or health system. The surgical management is associated with good outcomes.
