Delay in the presentation of symptoms and in referral of patients for surgical opinion remains an important problem in colorectal cancer. Factors influencing patients to consult early include advice from close family or other associates and abdominal pain or vomiting, or both, as one of the early symptoms. More localised rectal symptoms and loss of weight are often associated with long delay. The "classic" symptom pictures are not often seen in the early stages of the disease. Few identifiable factors were associated with delay in referral for surgical opinion. Doctors who examine their patients (rectally or otherwise) refer them sooner. In the districts studied delay in instituting definitive treatment after consultant referral does not seem to be a major problem. There is some evidence that delay is associated with stage of the disease at presentation.
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