Expeditious diagnosis and medical treatment following the discovery of signs or symptoms of rectal cancer greatly decreases morbidity and mortality. And yet, many patients with significant signs or symptoms delay seeking medical treatment. In addition, there is great variability among individuals in the length of time that elapses prior to medical consultation. Psychological factors are clearly implicated in many cases of delay, but are still not clearly understood. The immediate objective of this study is to identify psychological and psychosocial correlates of patient delay in seeking diagnosis as well as the cues that eventually prompt care-seeking. Patients who have recently been diagnosed with rectal cancer and who have just completed initial treatment will be recruited for a questionnaire study. Questions will serve to reconstruct the sequence of circumstances and events, beginning with the first occurrence of signs or symptoms of rectal cancer and ending with diagnosis and treatment. Patients will also complete three standardized psychological questionnaires. These questionnaires will serve to accomplish three interrelated aims.
The first aim i s to estimate the total length of time from detection of signs or symptoms of rectal cancer to pursuit of diagnosis, as well as to estimate the relative magnitudes of: 1) the time from the detection of signs or symptoms to the patient's inference of a serious medical problem (""""""""interpretation time""""""""), and 2) the time from the inference of a serious problem to the initiation of appropriate action (""""""""hesitation time"""""""").
The second aim i s to identify the proximal correlates of delay as well as the cues that trigger the accurate interpretation of symptoms and the initiation of appropriate action.
The third aim i s to identify personality and behavioral dispositions that correlate with delay. This project will result in information about the most common causes of delay as well as the cues that eventually prompt seeking diagnosis and treatment. The longer-term objective is to provide information that can be translated into the construction of more effective outreach educational and motivational programs, with the goal of facilitating earlier detection and treatment.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Small Research Grants (R03)
Project #
1R03CA084845-01
Application #
6072056
Study Section
Special Emphasis Panel (ZCA1-SRRB-X (O3))
Program Officer
Aziz, Noreen M
Project Start
1999-09-30
Project End
2001-09-29
Budget Start
1999-09-30
Budget End
2000-09-29
Support Year
1
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Washington University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
062761671
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Ristvedt, Stephen L; Trinkaus, Kathryn M (2009) Trait anxiety as an independent predictor of poor health-related quality of life and post-traumatic stress symptoms in rectal cancer. Br J Health Psychol 14:701-15
Ristvedt, Stephen L; Trinkaus, Kathryn M (2008) Sex differences in responding to rectal cancer symptoms. Psychol Health 23:935-944
Ristvedt, Stephen L; Birnbaum, Elisa H; Dietz, David W et al. (2005) Delayed treatment for rectal cancer. Dis Colon Rectum 48:1736-41
Ristvedt, Stephen L; Trinkaus, Kathryn M (2005) Psychological factors related to delay in consultation for cancer symptoms. Psychooncology 14:339-50