Colorectal Cancer: Determinants of Delayed Diagnosis and Its Association with Survival in the Pakistani Population

Background: New research indicates that Pakistan is seeing an increase in Colorectal cancer (CRC) cases among people older than 50. The main goal of this study is to find out the determinants of delayed diagnosis and their association with the survival of colorectal cancer patients in the Pakistani community. Methods: A prospective, cohort study was conducted on biopsy-proven colorectal cancer patients, aged between 18-70 years old presenting at the surgery department of Al Tibri medical college and Hospital, Karachi from January 1st, 2023 till March 30th, 2024, with a sample size of 98 patients, follow up duration was 1 year. A purposive sampling technique was used. Statistical Package of Social Sciences (SPSS) version 22 was used to enter, sort, and analyze the data. Kaplain–Meier was generated for survival analysis for both colon and rectal carcinoma. A P-value of ≤ 0.05 was considered significant. Results: Reasons for Delay in diagnosis were reported as misdiagnosis by a physician (OR 1.32, 0.24 – 2.16), poor knowledge of disease and symptoms (OR 2.48, 1.04 – 4.88), and herbal medication use to treat symptoms (OR 0.89, 0.047 – 1.89). Overall survival was reported as 74 (74.7%) for 1-year follow-up; however, Rectal cancer survival was 23 (23.7%), and colon cancer survival was 51 (51.3%) with a p-value of 0.365. Conclusion: In conclusion, patients with colorectal cancer in Pakistan are often diagnosed at an advanced stage, with a dismal prognosis, due to a delay in presentation.