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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.; Lyratzopoulos, G.; Card, T.; Chu, T.P.C.; Macleod, U.; Rachet, B.

Authors

C. Renzi

G. Lyratzopoulos

T. Card

T.P.C. Chu

B. Rachet



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.

Citation

Renzi, C., Lyratzopoulos, G., Card, T., Chu, T., Macleod, U., & Rachet, 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. The British Journal of Cancer, 115(7), 866-875. https://doi.org/10.1038/bjc.2016.250

Journal Article Type Article
Acceptance Date Jul 18, 2016
Online Publication Date Aug 18, 2016
Publication Date Sep 27, 2016
Deposit Date Jul 27, 2016
Publicly Available Date Mar 28, 2024
Journal British journal of cancer
Print ISSN 0007-0920
Electronic ISSN 1532-1827
Publisher Nature Publishing Group
Peer Reviewed Peer Reviewed
Volume 115
Issue 7
Pages 866-875
DOI https://doi.org/10.1038/bjc.2016.250
Keywords Symptomatic presentations, Primary care, Emergency diagnosis, Colorectal cancer, Data-linkage study
Public URL https://hull-repository.worktribe.com/output/441826
Publisher URL http://www.nature.com/bjc/journal/vaop/ncurrent/abs/bjc2016250a.html
Additional Information Copy of article first published in: British journal of cancer, 2016, v.115, issue 7.

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