Table 1 Study measurements

Patient

Age, gender, civil status, education, family history of cancer, symptom perception, confidence in the family doctor, and number of consultations until the first contact and reason for it.

Tumour

- Site, hystological grade, TNM at diagnosis.

Clinical:

- First symptom, data of the first symptom and other symptoms.

Delay intervals:

Patient-delay:

- Time elapsed from the date the patient perceived the first symptom until the date of the first contact with a doctor as a result of the first symptom/s.

Health system-delay. This delay distinguishes the following phases:

- Time elapsed between the first contact with the health system (consultation with the family doctor, specialist, or emergency department) and until the date of referral to a specialist.-

- Time elapsed between referral to a specialist or emergency department and until the diagnosis. In this context diagnosis is understood as the date of the biopsy or direct surgery if that was the case.

- Time elapsed between diagnosis and treatment. In this context we consider surgical treatment. Failing on that chemotherapy or palliative care treatment as the first option.

Total delay: Sum of all previous delays. There will be a distinction between diagnostic and therapy delay.

Health system.

- Health professional who attended the patient at the first visit: Family doctor or specialist including which speciality.

- Teaching versus non-teaching primary care centre; urban versus rural ones and receiving hospital. – Hospital service that attended the patient in the various contacts during the diagnostic process.

- Number of consultations to the family doctor; to primary care emergency services; and to the specialist since the first contact. Consultations cancelled with family doctor and specialist.

- Complementary examinations done at the first visit: rectal exam; abdominal palpation; ultrasound; blood tests; X Ray films. Delay duration for each of the complementary tests. – Request and date of complementary tests at each contact prior to diagnosis. Results of complementary tests in order to exclude false negatives.

- Type of referral done by the family doctor to the specialist: preferential; programmed; emergency department. Diagnostic assessment and referral details in terms of presenting clinical picture, physical examinations.