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Clinical features of colorectal cancer before emergency presentation: a population-based casecontrol study

Clinical features of colorectal cancer before emergency presentation: a population-based... Objective. To identify the clinical features of colorectal cancer presenting as a surgical emergency.Design. Population-based casecontrol study.Setting. All general practices in Exeter Primary Care Trust, Devon, UK.Participants. 349 patients with colorectal cancer, 62 of these having an emergency presentation. Five randomly selected controls matched by age, sex and general practice for each case.Data. The entire primary care record, from 24 months to 30 days before diagnosis, was coded using the International Classification of Primary Care-2.Main outcome measures. Symptom reporting by patients with emergency presentation of colorectal cancer compared with matched controls and non-emergency presentations.Results. Eight features of colorectal cancer were associated with the 62 emergency presentations of colorectal cancer. 39 (63%) of patients had reported at least one symptom to their doctors a minimum of 30 days before the diagnosis. In multivariable analysis, three features remained independently associated with cancer: abdominal pain, odds ratio 6.2 (95% CI 2.814), P < 0.001; loss of weight 3.4 (1.38.5), P 0.01; and diarrhoea 3.4 (1.25.7), P 0.02. When emergency presentations were compared with elective cases, abdominal pain was more common [interaction odds ratio 2.3 (1.63.3); P 0.047] and rectal bleeding less common [0.30 (0.08, 1.0); P 0.040].Conclusion. The majority of patients destined to have an emergency presentation of colorectal cancer have reported symptoms of their cancer to their doctor well before the emergency. Some emergency presentations should therefore be preventable. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Family Practice Oxford University Press

Clinical features of colorectal cancer before emergency presentation: a population-based casecontrol study

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References (14)

Publisher
Oxford University Press
Copyright
The Author (2006). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org
ISSN
0263-2136
eISSN
1460-2229
DOI
10.1093/fampra/cml059
pmid
17142248
Publisher site
See Article on Publisher Site

Abstract

Objective. To identify the clinical features of colorectal cancer presenting as a surgical emergency.Design. Population-based casecontrol study.Setting. All general practices in Exeter Primary Care Trust, Devon, UK.Participants. 349 patients with colorectal cancer, 62 of these having an emergency presentation. Five randomly selected controls matched by age, sex and general practice for each case.Data. The entire primary care record, from 24 months to 30 days before diagnosis, was coded using the International Classification of Primary Care-2.Main outcome measures. Symptom reporting by patients with emergency presentation of colorectal cancer compared with matched controls and non-emergency presentations.Results. Eight features of colorectal cancer were associated with the 62 emergency presentations of colorectal cancer. 39 (63%) of patients had reported at least one symptom to their doctors a minimum of 30 days before the diagnosis. In multivariable analysis, three features remained independently associated with cancer: abdominal pain, odds ratio 6.2 (95% CI 2.814), P < 0.001; loss of weight 3.4 (1.38.5), P 0.01; and diarrhoea 3.4 (1.25.7), P 0.02. When emergency presentations were compared with elective cases, abdominal pain was more common [interaction odds ratio 2.3 (1.63.3); P 0.047] and rectal bleeding less common [0.30 (0.08, 1.0); P 0.040].Conclusion. The majority of patients destined to have an emergency presentation of colorectal cancer have reported symptoms of their cancer to their doctor well before the emergency. Some emergency presentations should therefore be preventable.

Journal

Family Practice – Oxford University Press

Published: Nov 30, 2006

Keywords: Colorectal cancer diagnosis emergency admissions primary health care

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