Delay in diagnosis of colorectal cancer in elderly patients

The medical histories of 178 colorectal cancer patients were studied retrospectively from hospital records. The average age at the time of diagnosis was 71 years. Visible loss of blood or anaemia were the commonest features. The mean time from first symptom to first medical consultation was 82.8 days. Men under 65 years and women over 80 years waited the longest time before consulting a physician. The mean time from the first medical consultation to diagnosis was 44.7 days. The delay was longer for men than for women but longest for women aged over 80 years. Information about digital rectal examination was lacking in over half of all patients and in two-thirds of patients over 80 years. In patients in whom rectal examination had been made, as many as 60% of rectal cancers were digitally palpable. Barium enema missed the cancer diagnosis in 11.2% of patients at the first examination; the missed cancers were located in the sigmoid area and in the right colon. Colonoscopy can be recommended as the primary investigation method when colorectal cancer is suspected. Re-examination is necessary in elderly patients with sideropenic anaemia if the first examination is negative.