Improving colorectal cancer in Alberta, Canada: A qualitative study of patients and close contacts’ perceptions on diagnosis following an emergency department presentation

Abstract

Background: Colorectal cancer (CRC) is globally the third most prevalent cancer and a leading cause of cancer-related deaths. In Alberta, Canada, a significant portion of CRC diagnoses occur following emergency department (ED) presentations. Gaps remain in understanding patient’s perspectives on CRC diagnosis after an ED visit. The aim of this study was to examine the experiences and perspectives of a group of patients diagnosed with CRC subsequent to an ED visit in Alberta and their close contacts. Methods: We conducted a qualitative study using in-depth, semi-structured interviews with patients diagnosed with CRC after an ED visit at the Rockyview General Hospital, Calgary, and their close contacts, from November 2022 to June 2023. Interviews focused on symptom recognition, healthcare interactions, and the decision-making process leading to an ED visit. They were conducted in-person or over the phone, and analysed using thematic analysis. Results: Eighteen participants (12 patients and 6 close contacts) were interviewed, revealing four main themes: 1) variability in symptom recognition and interpretation; 2) inconsistencies in primary care consultations; 3) factors influencing decision-making leading to an ED visit; and 4) recommendations for expedited diagnosis outside of EDs. Conclusion: The findings highlight the complexity of the diagnostic journey for CRC patients in Alberta, pointing to significant gaps in symptom recognition, primary care responsiveness, and public awareness. Implementing targeted educational initiatives for both the public and healthcare providers may help to optimize early detection. Future research should focus on exploring novel interventions to address the identified barriers to timely CRC diagnosis.