Risk factors in patients presenting as an emergency with colorectal cancer

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Abstract
Of 905 patients with colorectal cancer admitted to a single district general hospital, 272 (30 per cent) were admitted as emergencies. Emergency patients had more advanced tumours (Dukes stage B and C 96 per cent versus 88 per cent of those admitted electively, P < 0·006), a shorter history (median 3 versus 11 weeks, P < 0·001), were less likely to be fully ambulatory (44 versus 80 per cent, P < 0·0001) and more likely to have abdominal pain (74 versus 51 per cent, P < 0·001) and vomiting (40 versus 10 per cent, P <0·0001). More emergency patients were given stomas (56 versus 35 per cent, P < 0·0001) and died in hospital (19 versus 8 per cent, P < 0·0001). Of those who survived to be discharged, patients admitted as an emergency spent longer in hospital (median stay 16 versus 13 days, P <0·0001) and had a poorer overall 5-year survival rate (29 versus 39 per cent, P = 0·0001). Emergency patients were significantly older (median 74 versus 72 years, P = 0·04) and much more likely to be widowed (41 versus 27 per cent, P = 0·0002) than those admitted for elective surgery. If the personal and resource disaster of emergency colorectal cancer admission is to be reduced, screening strategies targeted by demographic characteristics require investigation.

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