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Theprimary objective of study was to examine interval between symptom onset and definitive therapy in patients with colorectal cancer.One hundred and twenty-three patients whopresented with newly diagnosed colorectal cancer for surgery or chemotherapy were studied. Data on demography, past symptoms andprevious consultations were obtained by standardized questionnaires. Risk factors for delayed treatment were analyzed.The majority of patients (n = 86, 70%) suffered from colonic cancer. In 34 cases (28%), cancer was detected in asymptomatic stage by means of screening measures, including digital rectal examination. Total time between first symptoms and definitive therapy ranged from 13 to 442 days with a mean (SD) of 148 (92) days. Delays in start of surgical therapy were responsible for significantly higher tumour grades. On univariate analyses, delayed start of therapy was found to be correlated to type of cancer (rectal vs colonic), insurance (public vs private), marital status, and qualification of the first contact physician. On multivariate analyses, type of cancer, marital status, and insurance remained significantly associated with delayed treatment (all P values ≤ 0.001, r2 = 0.50).In Germany, delay in recognition and treatment of colorectal cancer varies by several months depending on social status and family background.