Format

Send to

Choose Destination
Br J Cancer. 2016 Sep 27;115(7):866-75. doi: 10.1038/bjc.2016.250. Epub 2016 Aug 18.

Do colorectal cancer patients diagnosed as an emergency differ from non-emergency patients in their consultation patterns and symptoms? A longitudinal data-linkage study in England.

Author information

1
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, WC1E 6BT London, UK.
2
Cancer Survival Group, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, WC1E 7HT London, UK.
3
Cambridge Centre for Health Services Research, University of Cambridge, CB2 0SR Cambridge, UK.
4
Division of Epidemiology and Public Health, University of Nottingham, NG5 1PB Nottingham, UK.
5
Nottingham Digestive Diseases Centre Biomedical Research Unit, University of Nottingham, NG7 2UH Nottingham, UK.
6
Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, NG7 2UH Nottingham, UK.
7
Hull York Medical School, University of Hull, HU6 7RX Kingston upon Hull, UK.

Abstract

BACKGROUND:

More than 20% of colorectal cancers are diagnosed following an emergency presentation. We aimed to examine pre-diagnostic primary-care consultations and related symptoms comparing patients diagnosed as emergencies with those diagnosed through non-emergency routes.

METHODS:

Cohort study of colorectal cancers diagnosed in England 2005 and 2006 using cancer registration data individually linked to primary-care data (CPRD/GPRD), allowing a detailed analysis of clinical information referring to the 5-year pre-diagnostic period.

RESULTS:

Emergency diagnosis occurred in 35% and 15% of the 1029 colon and 577 rectal cancers. 'Background' primary-care consultations (2-5 years before diagnosis) were similar for either group. In the year before diagnosis, >95% of emergency and non-emergency presenters had consulted their doctor, but emergency presenters had less frequently relevant symptoms (colon cancer: 48% vs 71% (P<0.001); rectal cancer: 49% vs 61% (P=0.043)). 'Alarm' symptoms were recorded less frequently in emergency presenters (e.g., rectal bleeding: 9 vs 24% (P=0.002)). However, about 1/5 of emergency presenters (18 and 23% for colon and rectal cancers) had 'alarm' symptoms the year before diagnosis.

CONCLUSIONS:

Emergency presenters have similar 'background' consultation history as non-emergency presenters. Their tumours seem associated with less typical symptoms, however opportunities for earlier diagnosis might be present in a fifth of them.

PMID:
27537389
PMCID:
PMC5046207
DOI:
10.1038/bjc.2016.250
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Nature Publishing Group Icon for PubMed Central
Loading ...
Support Center