Factors Influencing Late Consultation Among Patients with Rectal Bleeding in University Kebangsaan Malaysia Medical Centre


Background: Patients’ delay in the presentation with rectal bleeding had been identified as a factor for latediagnosis of colorectal cancer. This study was conducted to determine the prevalence of delay in consulting amedical practitioner and identifying associated factors. Materials and
Methods: A cross-sectional study of 80patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 inthe endoscopy unit, University Kebangsaan Malaysia Medical Centre. The self-administered questionnaireincluded data on sociodemographic, concern of rectal bleeding, whether patients sought initial advice, any selftreatment prior to medical consultation and patients’ opinion on causes of their own rectal bleeding.
Results:The prevalence of delay in the presentation of rectal bleeding was 60%. Patients who were less worried (OR 9.6;95% CI 3.3-27.5), who did not seek anyone’s advice (OR 11.8; 95% CI 3.8-36.8) and took some treatment beforeseeking medical consultation (OR 5.0; 95% CI 1.0-24.1) were significantly more likely to delay. Multiple logisticregression revealed that less worry of rectal bleeding and not seeking anyone’s advice were important predictors(p < 0.05). The majority of patients attributed their bleeding to benign causes.
Conclusion: A high proportion ofpatients with rectal bleeding in the high risk group delayed in seeking medical advice. Public education needsto focus on interventions to reduce the delay in presenting and diagnosis of colorectal carcinoma.