Colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women worldwide (Ferlay et al., 2015). Rates of CRC, however, have declined in many developed countries due to public health interventions on risk factors and screening, and it is predicted that further intervention may continue to reduce the disease burden (Edwards et al., 2010). Previous studies have found that time to diagnosis can affect survival rates of CRC. Delayed diagnosis has been associated with higher mortality, which may be due to cancer progression during the diagnostic period. Somewhat counterintuitively, a shorter time to diagnosis is also associated with an increased mortality rate because more aggressive cancers are often detected quickly (Pita-Fernández et al., 2016;Tørring et al., 2013), possibly due to more alarming symptoms at presentation (Afzelius et al., 1994;Caplan, 2014). Furthermore, patient perception of delayed diagnosis has been shown to increase patient distress (Miles et al., 2017).Therefore, assessing factors which may be associated with a longer time to diagnosis is an important goal for cancer control.
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