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

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 o...

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Main Authors: Renzi, C., Lyratzopoulos, G., Card, Timothy R., Chu, T., Macleod, U., Ratchet, B.
Format: Article
Published: Cancer Research UK 2016
Subjects:
Online Access:https://eprints.nottingham.ac.uk/35646/
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author Renzi, C.
Lyratzopoulos, G.
Card, Timothy R.
Chu, T.
Macleod, U.
Ratchet, B.
author_facet Renzi, C.
Lyratzopoulos, G.
Card, Timothy R.
Chu, T.
Macleod, U.
Ratchet, B.
author_sort Renzi, C.
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-356462024-08-15T15:20:03Z https://eprints.nottingham.ac.uk/35646/ 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, Timothy R. Chu, T. Macleod, U. Ratchet, B. 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. Cancer Research UK 2016-09-27 Article PeerReviewed Renzi, C., Lyratzopoulos, G., Card, Timothy R., Chu, T., 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, 115 (7). pp. 866-875. ISSN 1532-1827 Symptomatic presentations; primary care; emergency diagnosis; colorectal cancer; data-linkage study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5046207/ doi:10.1038/bjc.2016.250 doi:10.1038/bjc.2016.250
spellingShingle Symptomatic presentations; primary care; emergency diagnosis; colorectal cancer; data-linkage study
Renzi, C.
Lyratzopoulos, G.
Card, Timothy R.
Chu, T.
Macleod, U.
Ratchet, B.
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Symptomatic presentations; primary care; emergency diagnosis; colorectal cancer; data-linkage study
url https://eprints.nottingham.ac.uk/35646/
https://eprints.nottingham.ac.uk/35646/
https://eprints.nottingham.ac.uk/35646/