Missed Opportunities for the Diagnosis of Colorectal CancerReport as inadecuate




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BioMed Research International - Volume 2015 2015, Article ID 285096, 9 pages -

Research Article

College of Public Health, Temple University, Philadelphia, PA 19122, USA

Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, VA 23284, USA

Department of Methodology and Experimental Psychology, University of Deusto, Bilbao, 48007 Biscay, Spain

Department of Family Medicine, Case Western Reserve University, Cleveland, OH 44106, USA

Received 15 December 2014; Revised 24 March 2015; Accepted 28 April 2015

Academic Editor: Anne Miles

Copyright © 2015 Laura A. Siminoff et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To examine patient and medical characteristics which predict a missed diagnostic opportunity MDO for colorectal cancer CRC. Methods. The sample consisted of 252 patients diagnosed with Stages 1–4 CRC who were diagnosed in the prior six months, had experienced symptoms prior to diagnosis, and were not diagnosed through routine screening. Systematic review of all medical records prior to patients’ diagnosis was conducted. An MDO was defined as a clinical encounter where, even in the presence of presumptive CRC symptoms, the CRC diagnostic process is not started. Results. 92 patients 36.5% experienced an MDO. Almost 80% of alternate diagnoses were other GI-GU diseases, including hemorrhoids and diverticulitis. Stomach pain, anemia, and constipation were the most common symptoms experienced by the MDO group. These symptoms, and weight loss and vomiting, were more likely to be noted in the charts of the MDO patients . Independent risk factors for MDO included age <50 OR = 2.29 1.14–4.60, and female sex OR = 2.19 1.16–4.16, . Each additional physician seen, more than doubled the MDO risk OR = 2.05 1.53–2.74, . Conclusions. Females, younger patients, and those consulting more physicians were all more likely to experience an MDO. Continued increased training of physicians to enhance knowledge of who is vulnerable to CRC is needed in addition to an increased focus to adherence to screening recommendations.





Author: Laura A. Siminoff, Heather L. Rogers, and Sonja Harris-Haywood

Source: https://www.hindawi.com/



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