Patient Attribution of Colorectal Cancer Symptoms at Korle Bu Teaching Hospital

Abstract

Background: Delayed treatment of colorectal cancer (CRC) leads to poor outcomes, primarily due to patient misinterpretation of symptoms, late healthcare-seeking behaviour, and physician response. Records from Korle Bu Teaching Hospital (KBTH) indicate rising CRC cases since 2018, with patients’ symptom misattribution being a major contributor to late-stage diagnoses, resulting in higher mortality and poor prognosis. Limited public awareness of CRC symptoms exacerbates this issue, necessitating further research into patients’ symptom perceptions. Objective: This study examined patient attribution of CRC symptoms, associated factors, and the relationship between symptom attribution and patient interval (time from symptom recognition to medical consultation). Methods: A cross-sectional study analysed 218 CRC patients treated at KBTH (2018–2020) using interviewer-administered questionnaires (Kobo Collect). Data were analysed in STATA 16, with logistic regression assessing associations (p < 0.05 significance). Results: The mean age was 48.2 years (69% male). Key symptoms prompting medical visits were blood in stool (56.4%), change in bowel habits (64.7%), and abdominal pain (67.9%). Blood in stool was strongly linked to cancer attribution (cOR=13.1, p=0.014) and benign somatic causes (cOR=2.38, p=0.002). Older age predicted psychological (cOR=0.96, p=0.005) and lifestyle-related attributions (cOR=0.97, p=0.005). Patients attributing symptoms to lifestyle factors sought care faster in less than 20 days (aOR=1.96, p=0.046). Conclusion: Blood in stool, bowel changes, and abdominal pain were the most common symptoms driving healthcare visits. Misattribution delays care, particularly among older adults. Public education on CRC symptoms is critical to improve early detection. KBTH should prioritize community outreach to enhance symptom awareness and reduce late-stage diagnoses.