Perceived diagnostic delay and cancer-related distress: A cross-sectional study of patients with colorectal cancer

Anne Miles (Lead / Corresponding author), Paula L. Mcclements, Robert J. C. Steele, Claudia Redeker, Nick Sevdalis, Jane Wardle

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    50 Citations (Scopus)
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    Objective: This study aimed to examine the effect of perceived diagnostic delay on cancer-related distress and determine whether fear of cancer-recurrence and quality of life mediate this relationship. 

    Methods: Cross-sectional study in which 311 colorectal cancer (CRC) survivors in Scotland completed a survey, which included questions on cancer-related distress (IES-R), perceived diagnostic delay, quality of life (trial outcome index of the FACT-C: FACT-C TOI) and fear of cancer recurrence. Fifteen patients withheld consent to data matching with medical records, leaving a sample size of 296. Participants were an average of 69 years old (range 56 to 81) and between 3.5 and 12 years post-diagnosis. Multiple regressions were used to test predictors of distress and regression and bootstrapping to test for mediation. Results: Perceived diagnostic delay was correlated with higher cancer-related distress, while objective markers of diagnostic delay (disease stage at diagnosis and treatment received) were not. Some of the relationship between perceived diagnostic delay and cancer-related distress was mediated by quality of life, but not by fear of cancer recurrence. 

    Conclusions: Perceived diagnostic delay was associated with higher cancer-related distress among CRC survivors. While poorer quality of life partly explained such associations, fear of cancer recurrence, stage at diagnosis and treatment did not. The exact features of diagnostic delay that are associated with cancer-related distress remain unclear. Future research should examine the experiences patients go through prior to diagnosis that may increase distress, in an effort to improve our understanding of the factors affecting emotional wellbeing among CRC survivors.

    Original languageEnglish
    Pages (from-to)29-36
    Number of pages8
    Issue number1
    Early online date11 Feb 2016
    Publication statusPublished - Jan 2017

    ASJC Scopus subject areas

    • Oncology
    • Psychiatry and Mental health
    • Experimental and Cognitive Psychology


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