Knowledge of Colorectal Cancer and Delay in Presentation with Rectal Bleeding

Cancer has become one of the leading causes of death in the world and colorectal cancer is one of the most common cancers in Asian and Western countries (Bray et al., 2002). In Malaysia, colorectal cancer (CRC) ranks as the third commonest cause of cancer death and it is commonest in Chinese compared with other races (National Cancer Registry 2004; Rashid et al., 2009). Its incidence rises significantly for those above 40 years old. The key prognostic factor for survival in colorectal cancer is the stage of tumor at the time of presentation (Roncoroni et al., 1999) and therefore, early identification of the disease is crucial for improving survival. The most common and important symptom of colorectal cancer is rectal bleeding (Majmudar et al., 1999). It has the highest positive predictive value for colorectal cancer than other symptoms (Ferraris et al., 2004). Despite considerable advancement in the diagnostic methods, a delay in the diagnosis of colorectal cancer is still common (Roncoroni et al.,1999; Langebach et