Delay in the presentation of colorectal carcinoma: a review of causation

This review paper studies the reasons behind the delay in presentation of colorectal carcinoma. Such delay can occur at three different levels: delay on the part of the patient, delay by the general practitioner prior to patient referral and delay incurred at the hospital after patient referral. There is some evidence that patient delay has decreased in recent years; general practitioner delay is disputed by some authors, but there is considerable evidence that it exists. Hospital delay can be influenced by the general practitioner; there is evidence that it has increased in recent years and is likely to increase further with the current pressure on in-patient beds.