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

Renzi, C. and Lyratzopoulos, G. and Card, T. and Chu, T. and Macleod, U. and Ratchet, B. (2016) 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. British Journal of Cancer . ISSN 1532-1827 (In Press)

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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 nonemergency routes.

Methods: Cohort study of colorectal cancers diagnosed in England 2005-06 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, more than 95% of emergency and non-emergency presenters had consulted their doctor, but emergency presenters had less frequently relevant symptoms (colon cancer: 48% versus 71% (p<0.001); rectal cancer: 49% versus 61% (p=0.043)). ‘Alarm’ symptoms were recorded less frequently in emergency presenters (e.g. rectal bleeding: 9% versus 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 nonemergency presenters. Their tumours seem associated with less typical symptoms, however opportunities for earlier diagnosis might be present in a fifth of them.

Item Type: Article
Keywords: Symptomatic presentations; primary care; emergency diagnosis; colorectal cancer; data-linkage study
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
Depositing User: Claringburn, Tara
Date Deposited: 03 Aug 2016 09:01
Last Modified: 16 Sep 2016 01:43
URI: http://eprints.nottingham.ac.uk/id/eprint/35646

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