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Cancer Control Research

Abstract

Expeditious diagnosis and medical treatment following the discovery of signs or symptoms of rectal cancer greatly decreases morbidity and mortality. And yet, many patients with significant signs or symptoms delay seeking medical treatment. In addition, there is great variability among individuals in the length of time that elapses prior to medical consultation. Psychological factors are clearly implicated in many cases of delay, but are still not clearly understood. The immediate objective of this study is to identify psychological and psychosocial correlates of patient delay in seeking diagnosis as well as the cues that eventually prompt care-seeking. Patients who have recently been diagnosed with rectal cancer and who have just completed initial treatment will be recruited for a questionnaire study. Questions will serve to reconstruct the sequence of circumstances and events, beginning with the first occurrence of signs or symptoms of rectal cancer and ending with diagnosis and treatment. Patients will also complete three standardized psychological questionnaires. These questionnaires will serve to accomplish three interrelated aims. The first aim is to estimate the total length of time from detection of signs or symptoms of rectal cancer to pursuit of diagnosis, as well as to estimate the relative magnitudes of: 1) the time from the detection of signs or symptoms to the patient's inference of a serious medical problem ("interpretation time"), and 2) the time from the inference of a serious problem to the initiation of appropriate action ("hesitation time"). The second aim is to identify the proximal correlates of delay as well as the cues that trigger the accurate interpretation of symptoms and the initiation of appropriate action. The third aim is to identify personality and behavioral dispositions that correlate with delay. This project will result in information about the most common causes of delay as well as the cues that eventually prompt seeking diagnosis and treatment. The longer-term objective is to provide information that can be translated into the construction of more effective outreach educational and motivational programs, with the goal of facilitating earlier detection and treatment.