Abstract
ABSTRACTBackground: Colorectal cancer (CRC) is a potentially fatal disease, and expedited referral and treatment is needed to ensure early detection.Objective: We aimed to assess the symptomatology of Greenlandic patients with CRC and the primary investigations initiated before referral to Dronning Ingrids Hospital in Nuuk for further diagnostic workup. Primary care interval (first consultation until referral), hospital interval (referral until diagnosis) and diagnostic interval (first consultation until diagnosis) were calculated and compared between patients living in Nuuk and in other places in Greenland (“the Coast”).Design: This was a retrospective, register-based study of all patients in Greenland diagnosed with CRC from 2008 through 2011. Medical history was obtained and investigated by reviewing the primary care charts.Results: In total 113 patients were identified from the Greenlandic cancer database or pathology reports. About 80% of the patients were asked about blood in the stools and changes of bowel habits, and the majority responded positively to this. Abdominal examination was performed for 78%, 65% had a rectal examination performed, 22% a proctoscopy performed and 51% a haemoglobin level measured.The median primary care interval was 4 days in Nuuk vs. 55 days for patients from “the Coast” (p=0.01); the median diagnostic interval was 55 days in Nuuk vs. 95 days for patients from “the Coast” (p=0.04). Median hospital interval was similar for both groups (23 days vs 24 days; p=0.86). Women had a median primary care interval of 70 days vs. 15 days for men (p=0.06).Conclusions: Patients with CRC presented classic symptomatology of CRC. Primary care interval and diagnostic interval were significantly longer for patients from “the Coast” compared with Nuuk. Women tended to have longer primary care interval. A more standardised examination should be implemented and a national CRC screening programme should be considered to reduce the difference in diagnostic interval and ensure timely referral.
Highlights
Colorectal cancer (CRC) is the second most commonly diagnosed cancer in Greenland, only surpassed by lung cancer, and it is a frequent cause of morbidity and mortality [1]
The cost effectiveness of a national population screening programme for CRC is under investigation, but at present only patients with a family history are screened and only patients suspected for CRC are referred to further diagnostics
We found no valid data on CRC mortality rates in Greenland
Summary
Colorectal cancer (CRC) is the second most commonly diagnosed cancer in Greenland, only surpassed by lung cancer, and it is a frequent cause of morbidity and mortality [1]. Two of the major aims of the national plan against cancer are early diagnosis and to strengthen the collaboration around the patient between different parts of the health care system. Regarding CRC, the national plan against cancer recommends closer surveillance of incidence, treatment and survival [2]. In Greenland the epidemiological aspects of CRC are not well described, but a cohort study from 1973 to 1997 showed an increase in CRC comparable with the incidence seen in Denmark at that time [3]. In a study including data from 2000 to 2009 [4] a slightly lower incidence rate of CRC was found in Greenland, compared with Denmark. We found no valid data on CRC mortality rates in Greenland. Colorectal cancer (CRC) is a potentially fatal disease, and expedited referral and treatment is needed to ensure early detection
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
